About the role

Manager / Deputy Manager – US Health Insurance Claims Adjudication

Job Summary:

We are looking for an experienced Manager / Deputy Manager to oversee day-to-day US Health Insurance Claims Adjudication and Back-Office Operations . The candidate will be responsible for managing large teams, ensuring operational efficiency, meeting SLAs/KPIs, maintaining quality, and driving continuous process improvements.

Key Responsibilities:

Oversee day-to-day US health insurance claims adjudication and back-office operations .
Manage and lead a large team of 80+ employees through Team Leaders/Supervisors .
Ensure timely and accurate processing while consistently meeting or exceeding SLAs and KPIs .
Monitor transactions and performance and take corrective actions wherever required.
Drive process improvements to enhance productivity, quality, accuracy, and turnaround time .
Provide coaching, feedback, and performance guidance to Team Leaders and their teams.
Support new-hire training and ensure employees become productive within the required timeframe.
Handle process-level escalations and identify root causes to implement effective solutions.
Provide inputs on process, system, and workflow improvements.
Manage client interactions and escalations as required.
Ensure compliance with internal policies, procedures, external regulations, and information security standards.
Collect, analyze, and provide data required for various audits.
Ensure teams understand their goals and how they align with the organization's quality objectives .

Requirements:

10+ years of experience in US Health Insurance Claims Adjudication .
Currently working as a Manager or Deputy Manager .
Must have experience managing Team Leaders / Supervisors .
Large team handling experience of 80+ employees is mandatory.
Strong understanding of US healthcare/health insurance claims processes and medical terminology.
Candidates without hands-on US Health Insurance Claims Adjudication experience will not be considered.

Preferred Qualifications:

Proven experience in large-scale team management (80+ FTEs) .
Strong analytical and problem-solving abilities.
Excellent coaching and feedback skills.
Clear written and verbal communication.
Strong understanding of SLA, KPI, quality, productivity, and compliance metrics .

Benefits:

Competitive salary and performance-based bonuses.
Comprehensive health insurance packages.
Opportunities for professional development and career advancement.
Supportive and collaborative work environment.
Flexible working hours and potential for remote work options.
Generous paid time off and holidays.
Employee wellness programs and initiatives.