Job Description

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Lead and manage a team of Non-Medical Claims Adjudicators handling Cashless and Reimbursement health insurance claims.
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Ensure timely and accurate adjudication of claims in accordance with policy terms, company guidelines, and regulatory requirements.
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Monitor daily claim inventories, workload distribution, and claim pendency to ensure productive operations.
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Supervise and review the performance of team members, providing regular coaching, feedback, and support.
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Conduct supervisor audits of processed claims to ensure adherence to quality standards and operational procedures.
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Oversee the activities of the DEO and Inward teams, ensuring accuracy and timely completion of assigned tasks.
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Review and analyze daily operational reports related to claim processing, productivity, quality, and turnaround times.
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Handle escalated cases and coordinate with internal stakeholders for effective resolution of issues.
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Ensure error-free data capture and maintain high standards of quality across the claims processing lifecycle.
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Drive process improvement initiatives to enhance operational efficiency and customer experience.
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Promote the use of digital tools and technologies, including OCR-based processing, to improve automation and productivity.
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Identify training needs and facilitate skill development programs for team members.
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Support compliance, audit, and risk management requirements by ensuring adherence to established processes and controls.
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Prepare management reports and provide insights on team performance, operational trends, and improvement prospects.
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Foster a team-oriented, high-performance work environment focused on service excellence and continuous improvement.
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📌 Senior Manager Health Claims Noida (India)
🏢 TATA AIG General Insurance Company
📍 India