Description
Primary Duties:
- Create an inspiring team environment with an open communication culture
- Driving productivity goals set for project with defined quality metrics achieved
- Delegate tasks and set deadlines
- Oversee day-to-day operation
- Monitor team performance and report on metrics
- Motivate team members
- Discover training needs and provide coaching
- Hires, trains, coaches, counsels, and evaluates performance of direct reports
- Listen to team members’ feedback and resolve any issues or conflicts
- Handling calibration calls across Vendors/ Anthem support
- Leading weekly calls with the Business stakeholders
- Recognize high performance and reward accomplishments
- Encourage creativity and risk-taking
- Heavy involvement in people management and engagement activities
- Ideation and process improvement initiatives
- Being an ambassador of company norms and policies Be a liaison between management & team , Communicate difficult message with grace"
Secondary Duties:
- Performs audits to monitor efficiency and compliance with policies
- Provides quality control services by monitoring work results of direct reports
- Identifying trends in team members in terms of performance and behavior and take initiatives to groom and mentor them to the next level
- Adhering to the communication framework between Management and team members thereby ensuring that everyone contributes to a shared vision
- Participate in organization level activities.
- Coordinate with other departments for value added initiatives.
- Training as per business requirement.
- Adhoc tasks as per business requirements.
- Candidate would be subject to routine business screening. Work under min supervision
Skills:
- Flexible to work in any shift
- Strong people management capability and analytical thought process
- Proficient in MS office - Excel and PowerPoint
- Excellent communication skills - Verbal and Written
- Proven work experience as a team leader or supervisor
- In-depth knowledge of performance metrics
- Organizational and time-management skills
- Decision-making skills
- Excellent Work ethics
- Team Management
- Conflict Management
- Stakeholder Management and Interaction
- Emotional Intelligence
- Analytics & Reporting
- Performance Management
- Coaching & Mentoring
- Delivery Management
- Implemented fast-track and Best in class Claims pratices toreduce Rework
- Strong understanding of Interest payment and different teams levers/improvement opportunities
- Experience of working with Upstream/downstream processes for enhanced performance
- Understanding Adjutement Reason codes and value driven preposition
- Handled 1 project in last 12 months with quantified benefit (>5 FTEs)"
Education: Graduation
Experience:
- 7+ years of experience, with 3+ yrs. supervisor/ leadership role in Claims Rework (Correspondence, Adjustments of original Incorrect claims processing, Recovery, Dispute resolution)
- Healthcare experience
Certifications: AHM250 / Any certification from AAHM / Six Sigma GB certification
Skills & Competencies: Claims knowledge/ Claims adjudication process
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