Role:-
- Should have sound end to end claims processing knowledge of healthcare claims
- Excellent interpersonal skills, including listening, verbal and written communication with the abilityto communicate effectively
- Negotiation and settlement skills
- Able to build excellent relationships with internal and external customers.
- Numerate with the ability to present and analyze data
- Proactive approach
- Problem-solver
- Position Summary:-
Gallagher Center of Excellence is seeking to hire a AM/DM -Claims Operations. As the Claims Lead, you will be responsible to Supervise and handle a team of Claims examiners in the best interests of the company, by delivering a high-quality cost-effective claims service to customers and contribute to the delivery of the claims business goals, within claims handling authorities.
Your role will involve delivery of key SLAs, set goals, monitor and evaluate staff progress, assist with training and queries, and manage stakeholder expectations. Additionally,
you may also carry an individual case load based on business needs.
You will be responsible for fostering a culture of collaboration, continuous improvement, and customer focus within the shared services team. You will be interacting with the team who are present in UK/US/ANZ. Exposure to Insurance regulations and laws, claims handling procedures and Risk management principles is a definite plus.
Responsibilities:-
Supervise a team of healthcare claims examiners and may carry an individual case load based on business needs.
Actively manage work allocation, , query resolution and delivery of key SLAs
Report key claims handling metrics using dashboards & scorecard to evaluate performance and trends and drive process improvements
Review work of others via file reviews; identify coaching opportunities and act on needed coaching opportunities
Identify performance and behavioral issues and work with staff and ma