Asst. Manager Claim Adjudication(Facets)

Manage attrition and shrinkage, including tracking trends, identifying root causes, and implementing corrective actions.

Asst. Manager Claims Adjudication(FACETS)

Location: Infopark, Kochi,Kerala

Qualification: Any Degree

Experience: Minimum 5+ Years in claims Adjudication &minimum 1yr of team leading experience

Minimum 1-1.5 yrs of FACETS experience is Manadtory

Salary: 8-10LPA

Shift: 6:00 PM 3:00 AM


Requirements

• Bachelors degree or equivalent qualification in any discipline.
  
• Minimum 5 years of experience in US healthcare claims adjudication, preferably with team-handling/leadership experience.
  
• Proven experience in team leadership and people management within a healthcare claims/BPO environment.
  
• Strong understanding of the US healthcare insurance and claims lifecycle.
  
• Good knowledge of eligibility, benefits, claims processing, payment, denials, adjustments, and reprocessing.
  
• Demonstrated experience in attrition and shrinkage management.
  
  
  
  

Responsibilities

• Lead and manage a team handling US healthcare claims adjudication processes.

• Provide effective people management, coaching, mentoring, and performance management to the team.

• Review and adjudicate US healthcare claims accurately in accordance with payer guidelines and client requirements.

• Verify member eligibility, benefits, coverage, provider information, and claim details.

• Handle claim adjustments, corrections, reprocessing, and other complex claim-related issues.