About the role

Manager / Deputy Manager – US Health Insurance Claims Adjudication

Experience: 9–12 Years
Designation: Manager / Deputy Manager
Location: Noida
Shift: US Shift
Work Mode: Work from Office
Notice Period: Immediate to 45 Days
Qualification: Any Graduate

Job Overview

We are looking for an experienced Manager / Deputy Manager to lead large-scale US Health Insurance Claims Adjudication operations. The role will be responsible for managing end-to-end back-office claims operations, leading Team Leaders and a large team, ensuring adherence to SLAs/KPIs, quality, productivity, and client requirements.

Key Responsibilities

Lead and manage a large operations team of 80+ members , including Team Leaders/Supervisors.
Oversee day-to-day US Health Insurance Claims Adjudication and back-office operations.
Ensure claims are processed accurately and within defined turnaround time and SLA requirements.
Monitor team performance, productivity, quality, accuracy, and other operational KPIs.
Manage and mentor Team Leaders to drive overall team performance and operational excellence.
Provide coaching, feedback, and performance improvement support to Team Leaders and team members.
Handle operational escalations and ensure timely resolution of critical issues.
Identify process gaps and implement corrective actions and continuous improvement initiatives.
Ensure new hires are effectively trained and achieve productivity within the defined timeline.
Coordinate with internal stakeholders and clients for operational requirements and performance reviews.
Ensure compliance with internal policies, information security standards, and audit requirements.
Collect, analyze, and provide operational data for audits, governance, and management reporting.
Ensure team members understand their goals and alignment with organizational quality and performance standards.

Mandatory Skills

9–12 years of relevant experience in US Healthcare / US Health Insurance Operations.
Mandatory hands-on experience in US Health Insurance Claims Adjudication.
Must have experience managing a large team of at least 80+ employees .
Candidate should currently be working as a Manager or Deputy Manager .
Must have experience in managing Team Leaders/Supervisors .
Strong experience in back-office operations, SLA/KPI management, productivity, and quality management.
Experience in handling operational escalations and client interactions.
Strong people management, coaching, and performance management skills.
Good understanding of US healthcare processes and medical terminology.
Strong analytical, problem-solving, and stakeholder management skills.

Qualification

Any Graduate
Relevant experience in US Health Insurance Claims Adjudication is mandatory.