Team Lead Operations

22 hours ago

Indore, Madhya Pradesh, India Aegan Technologies Private Limited Full time ₹ 15,00,000 - ₹ 25,00,000 per year

Job Title: Team Lead Operations – Claims Adjudication (US Healthcare)

Location: [Indore]

Experience: Minimum 4.6 years in US Healthcare Claims Adjudication, including at least 1 year as SME (on papers)

Role Overview

The Team Leader – Claims Adjudication is responsible for supervising a team of claims processors/adjudicators to ensure accurate and timely adjudication of healthcare/insurance claims in alignment with policies, compliance standards, and service-level agreements (SLAs). The role requires strong domain expertise, people management, and quality oversight, along with the ability to drive operational excellence and continuous improvement.

Key Responsibilities

  • Lead and manage a team of claims adjudicators to meet daily/weekly/monthly SLA targets.
  • Monitor claim processing accuracy and ensure compliance with HIPAA, CMS, and client-specific regulations.
  • Conduct regular quality audits and implement corrective action plans where needed.
  • Act as Subject Matter Expert (SME) to resolve escalations and provide process guidance.
  • Manage team schedules, productivity tracking, and performance appraisals.
  • Deliver training, coaching, and mentoring to enhance team capability and efficiency.
  • Collaborate with Quality, Training, and Operations teams to address process gaps.
  • Drive process improvement initiatives to reduce errors and improve turnaround times.
  • Prepare and share daily/weekly/monthly reports with management and clients.
  • Ensure adherence to compliance, data privacy, and organizational policies.

Required Skills & Qualifications

  • Minimum 4.6 years of experience in US Healthcare Claims Adjudication.
  • At least 1 year of proven experience as SME (on papers).
  • Strong knowledge of healthcare claims adjudication processes and compliance frameworks.
  • Good communication skills (oral & written) with ability to manage client interactions.
  • Strong leadership, team management, and conflict resolution skills.
  • Proficiency in MS Office tools (Excel, PowerPoint, Word) for reporting and analysis.
  • Ability to work in a fast-paced environment with high attention to detail.

If your interested send your resume to -

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Job Type: Full-time

Work Location: In person

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