Role Description

: Senior BPO Claims Processor –

- Lead Experience: 8+ YearsRole: Senior BPO Claims Processor –
- LeadJob Type: Full-timeFunction: BPO / Claims OperationsLevel: Lead Job Summary We are seeking an experienced Senior BPO Claims Processor –
- Lead with 8+ years of experience in claims processing and BPO operations. The candidate will be responsible for managing day-to-day claims operations, handling complex and escalated claims, guiding a team of processors, and ensuring achievement of defined productivity, quality, turnaround time (TAT), and SLA targets. The ideal candidate should possess strong claims-processing knowledge along with proven capabilities in team leadership, quality management, operational reporting, escalation management, process improvement, and client/stakeholder communication.

Key Responsibilities Claims Processing &
- Operations Manage and oversee end-to-end claims-processing activities within the assigned process/workstream. Process and review complex, high-value, or exception claims requiring senior-level intervention. Validate claim information and supporting documentation for completeness and accuracy. Identify processing discrepancies, exceptions, and missing information and facilitate appropriate resolution. Ensure claims are processed according to established SOPs, business rules, quality standards, and contractual SLAs. Monitor daily claim volumes, pending inventory, aging, and backlogs and prioritize work accordingly. Ensure timely resolution of claims requiring additional investigation or escalation.

Team Leadership

Lead and provide day-to-day guidance to a team of claims processors. Allocate workload based on transaction volumes, priorities, complexity, and SLA requirements. Support team members in resolving complex claims and process-related queries.

Conduct regular team huddles and communicate process updates, client requirements, and operational priorities. Coach and mentor team members on process knowledge, accuracy, productivity, and quality. Support new-hire onboarding, training, and knowledge-transfer activities.





Act as the first level of escalation for operational and process-related issues. SLA, Quality &

- Performance Management Monitor operational metrics such as productivity, accuracy, quality, TAT, SLA compliance, backlog, aging, and rework. Review team performance and identify areas requiring corrective actions or additional training.

Perform Root Cause

Analysis (RCA) for recurring processing errors, quality failures, and SLA misses. Coordinate corrective and preventive actions with Operations, Quality, and Training teams. Ensure documentation and audit requirements are followed consistently. Client &
- Stakeholder Management Handle client/internal stakeholder queries and operational escalations professionally. Participate in daily/weekly operational reviews and governance meetings as required. Provide accurate updates on volumes, backlog, quality, productivity, SLA performance, risks, and issues. Coordinate with Quality, Training, Workforce Management, Technology, and other support functions for timely issue resolution. Maintain strong communication and working relationships with relevant stakeholders.

Process

Improvement &
- Governance Identify opportunities to improve processing efficiency, quality, and turnaround time. Recommend process standardization and automation opportunities. Analyze operational trends and recurring exceptions and propose sustainable solutions. Support preparation and maintenance of SOPs, process maps, checklists, knowledge documents, and training materials. Participate in change management, transition, migration, and process-improvement initiatives.

Primary Skills Claims





Processing / Claims Operations End-to-End Claims Management Claims Review and Validation Complex Claims / Exception Handling Team Leadership and People Management SLA and TAT Management Quality and Productivity Management Backlog and Inventory Management Escalation Management Root Cause Analysis (RCA) Client / Stakeholder Management Operational Reporting and Governance Solid written and verbal communication Secondary / Preferred Skills Advanced working knowledge of Microsoft Excel MIS and dashboard reporting SOP and process documentation Process improvement and standardization Training and knowledge transfer Workforce/workload planning Lean / Six Sigma exposure or certification Experience supporting process transitions or migrations Exposure to workflow automation or digital transformation initiatives Key Competencies Strong leadership and team-management skills Excellent attention to detail Analytical and problem-solving ability Strong decision-making skills Ability to manage high-volume operations Effective prioritization and workload management Strong communication and interpersonal skills Client-oriented mindset Ownership and accountability Ability to work effectively in a target-driven and SLA-based environment Education &

Experience Bachelor’s degree in Business Administration, Commerce, Finance, Healthcare Management, or a related field. Minimum 8 years of relevant BPO/claims-processing experience. Prior experience in a Lead, Senior Processor, SME, or equivalent role is strongly preferred. Demonstrated experience handling complex cases, operational escalations, quality issues, and team coordination.

Preferred Candidate Profile An experienced claims professional who combines strong hands-on processing expertise with operational leadership capabilities. The candidate should be capable of independently managing a claims workstream, guiding processors, handling escalations, monitoring operational KPIs, interacting with stakeholders, and driving improvements in quality and productivity.

Skills

Claims Management, Incident Management, Technical Leadership, Process Documentation, Exception Handling, GRC, Reporting and Analytics, Quality Management, Process Improvement, Service Level Management, Stakeholder Management

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