Team Leader - Insurance

Afni, Inc.; Quezon City; On-site; PHP 502,000 - 725,000; Full time

Job summary

Afni, Inc. in the Philippines seeks a Team Lead to guide claims representatives in accurate medical bill reviews for auto insurance claims. You will ensure adherence to standards and regulatory requirements, and drive best practices in processing.

The role includes coaching, performance monitoring, audits, and process improvements to enhance accuracy, timeliness, and customer satisfaction.

Qualifications

• At least 2 yrs of college.
• 1 year in a supervisory/lead role preferred in Health and P&C insurance.
• Strong leadership and interpersonal skills.

Responsibilities

• Coach and mentor claims reps on medical bill review procedures and compliance.
• Monitor team performance and provide actionable feedback.
• Conduct audits/quality checks for consistency with policy.
• Collaborate with leadership to identify gaps and implement improvements.
• Serve as SME on medical bill review protocols (state requirements like PIP/MedPay).
• Support escalated claim resolution and provider communication.
• Track performance metrics and assist with reporting.

Skills

Leadership

Communication

Analytical thinking

Problem solving

MS Office

Education

Two years of college

Job description

Position Purpose:

The Team Lead is responsible for leading and supporting claims representatives in the accurate and efficient review of medical bills related to auto insurance claims. This role ensures adherence to standards, regulatory requirements, and best practices in medical bill processing. Process Coach provides ongoing training, performance feedback, and process improvement guidance to enhance team effectiveness and customer satisfaction.

Description

The Team Lead is responsible for leading and supporting claims representatives in the accurate and efficient review of medical bills related to auto insurance claims. This role ensures adherence to standards, regulatory requirements, and best practices in medical bill processing. Process Coach provides ongoing training, performance feedback, and process improvement guidance to enhance team effectiveness and customer satisfaction.

Essential Functions and Responsibilities:

• Coach and mentor claims representatives on medical bill review procedures, documentation standards, and compliance requirements


• Monitor team performance and provide actionable feedback to improve accuracy, timeliness, and service quality


• Conduct audits and quality checks on processed claims to ensure consistency and adherence to policy


• Collaborate with leadership to identify process gaps and implement improvements


• Serve as a subject matter expert on medical bill review protocols and state-specific requirements (e.g., PIP, MedPay)


• Support escalated claim resolution and provider communication when needed


• Track performance metrics and contribute to reporting and analysis for operational insights.

Requirements

Minimum Job Requirements (Experience, Skills):

• Education: At least 2yrs of college


• Experience: Minimum 1 year in a supervisory or team lead role, preferably in Health and P&C insurance in data Capture Program


• Skills:
  
  
  
  • Strong leadership and interpersonal skills
  
  
  • Excellent verbal and written communication
  
  
  • Analytical thinking and problem-solving
  
  
  • Proficiency in MS Office and workflow management tools
  
  
  • Ability to manage time and prioritize tasks effectively