Role Description

At UST, we help the world’s best organizations grow and succeed through transformation. Bringing together the right talent, tools, and ideas, we work with our client to co-create lasting change. Together, with over 30,000 employees in 30+ countries, we build for boundless impact—touching billions of lives in the process. Visit us at .

Summary

UST is looking for….

&B; Lead –

- BPM (Business Process Management) Role Summary The Enrollment &
- Billing (E&B;) Lead is responsible for end-to-end operational leadership of member enrollment and billing services performed in TriZetto Facets. The role oversees enrollment maintenance, eligibility validation, 834 file fallout, reporting, payment reconciliation, communications support, quality governance, inventory management, service-level performance, and Business Process Management (BPM) initiatives for standard work and National Accounts to drive operational excellence, process optimization, and continuous improvement.

Key Responsibilities Operations Management Own daily enrollment and billing delivery across standard work and National Accounts. Manage work allocation, queue balancing, inventory aging, productivity, staffing coverage, and priority requests. Oversee enrollment additions, changes, terminations, demographic updates, eligibility validation, and billing reconciliation activities in TriZetto Facets.

Ensure secure handling and retention of enrollment and billing documentation according to approved procedures. Drive BPM best practices to improve operational efficiency, process standardization, and workflow effectiveness. Enrollment &

- Eligibility Oversight Provide functional oversight for new member enrollment, member maintenance, subgroup changes, Medicare Supplement enrollment, and spousal discount eligibility. Guide resolution of fallout from employer self-service tools, BenefitFocus Enrollment Center, enrollment reports, and 834 electronic files. Oversee new and renewing 834 file implementation and maintenance. Coordinate urgent, custom, dual-year, full-file, and spreadsheet-based National Accounts enrollment requests when assigned. Billing &
- Reconciliation Oversight Oversee cash receipt review and reallocation to applicable subgroups in TriZetto Facets without handling cash. Guide member-level reconciliation of billed and paid amount variances. Oversee balances associated with terminated groups and custom National Accounts billing and payment reports. Provide escalation support for delinquency, cancellation, reinstatement, aging, and complex reconciliation work. Quality, Compliance &




- Governance Drive first-time-right processing, quality calibration, root cause analysis, corrective action, and defect prevention. Ensure timely escalation and resolution planning for regulatory, audit, and compliance issues. Monitor service-level performance for enrollment, billing, communications, and compliance obligations. Ensure processing follows approved desktop procedures, controls, and change management requirements.

Stakeholder

Management &
- Reporting Partner with Client operations leads, SMEs, employer groups, plan administrators, QA, training, compliance, and technology teams. Lead weekly operational reporting covering delivery, inventory, production, issues, risks, decisions, and support needs. Support monthly service performance reporting and governance reviews. Oversee timely inbound and outbound phone and email communications, critical issue escalation, and inquiry resolution.

People

Leadership &
- Improvement Coach analysts and QA analysts across low-, mid-, and high-complexity work. Support training, cross-skilling, readiness validation, and performance improvement. Identify opportunities for standardization, workflow optimization, reporting improvements, automation, and BPM-driven process enhancements. Lead continuous improvement initiatives and process transformation activities.

Mandatory

Skills &

Competencies Deep knowledge of US healthcare payer enrollment, eligibility, membership, and premium billing operations. Robust hands-on knowledge of TriZetto Facets enrollment and billing workflows. Understanding of 834 transactions, eligibility fallout, member maintenance, subgroup structures, cash receipt reallocations, and billing reconciliation.

Strong leadership, inventory management, escalation, reporting, and stakeholder communication skills. Ability to manage tiered complexity, National Accounts work, and regulatory or audit-sensitive processes. Strong knowledge of Business Process Management (BPM), process improvement, workflow optimization, SOP governance, and operational excellence methodologies.

Qualifications Education Bachelor's degree in Healthcare Administration, Business, Finance, Information Systems, or a related field.

Experience 8+ years in US healthcare payer enrollment, membership,



eligibility, or billing operations. Minimum 2+ years in a team lead, SME, or supervisory capacity.

Experience in high-volume, SLA-driven healthcare operations.

Experience leading BPM, process improvement, or operational excellence initiatives is preferred.

Required Platform

Hands-on experience with TriZetto Facets enrollment and billing functions.

Key Performance

Indicators (KPIs) Enrollment processing accuracy Billing reconciliation accuracy Enrollment and billing turnaround-time adherence Communications response and resolution adherence Inventory aging and backlog reduction Productivity attainment Defect leakage and repeat-error reduction Timely compliance escalation and remediation Member and provider satisfaction results Process improvement outcomes, workflow efficiency gains, and BPM initiative success metrics.

What You Need

BTech/ MCA/ BCA/Msc IT/Bsc IT

Required Skills

Claims Management, FACETS, TriZetto, Healthcare Systems

What You Need

What we believe

We’re proud to embrace the same values that have shaped UST since the beginning. Since day one, we’ve been building enduring relationships and a culture of integrity. And today, it's those same values that are inspiring us to encourage innovation from everyone, to champion diversity and inclusion and to place people at the centre of everything we do.

Humility

We will listen, learn, be empathetic and help selflessly in our interactions with everyone.

Humanity

Through business, we will better the lives of those less fortunate than ourselves.

Integrity

We honour our commitments and act with responsibility in all our relationships.

Equal Employment Opportunity Statement

UST is an Equal Opportunity Employer. We believe that no one should be discriminated against because of their differences, such as age, disability, ethnicity, gender, gender identity and expression, religion, or sexual orientation.

All employment decisions shall be made without regard to age, race, creed, colour, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law.

UST reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

- To support and promote the values of UST.
- Comply with all Company policies and procedure

Skills Claims Management, FACETS, TriZetto, Healthcare Systems

📌 Lead I - BPM (Thiruvananthapuram)
🏢 UST
📍 Thiruvananthapuram