Claims Supervisor
On-siteBengaluru, Karnataka, India
Job Summary
Supervise day-to-day claims processing operations to meet SLA/TAT, productivity, and quality targets while allocating work, managing volumes, and ensuring queue hygiene. Guide the team on claims handling across intake, validation, adjudication, and COB, ensuring correct application of eligibility, benefits, pre-auth, and medical necessity indicators. Drive adherence to SOPs, conduct regular audits, and coach for error reduction while maintaining documentation for governance and HIPAA compliance. Set clear expectations, conduct huddles and 1:1s, and manage attendance and schedule adherence for a team of 12-15 members. Provide daily operational updates to managers and cross-functional teams, participate in client calls, and lead mini-projects to improve First Pass Yield and reduce rework.
Required Qualifications
- 5–6 years of experience in International Healthcare Claims Operations (payer/TPA/provider revenue cycle claims teams supporting payer processes)
- Minimum 3-4 years in a lead/team supervisor/team lead
- Strong understanding of claims concepts: adjudication flow, denials, adjustments, benefits/eligibility basics
- Ability to interpret SOPs, apply judgement, and drive operational discipline
- Excellent communication (verbal/written), stakeholder management, and people leadership skills
- Strong working knowledge of MS Office (Excel, PowerPoint); comfort with dashboards and trackers
- Minimum 5 years in EU/US/Global health insurance claims industry
- hands-on experience on claims processing of at least 4 years
- 3-4 years in managing team of 12-15 members/associates
Desired Qualifications
- Experience with claims platforms/workflows (payer tools)
- OCR/intake tools
- BPM/queue management systems
- Exposure to Lean/Six Sigma, Kaizen, or structured CI methods
- Prior experience working in regulated environments with audit rigor (internal/external)
- Familiarity with provider contracting concepts and network/COB scenarios
- Code familiarity: CPT/HCPCS/ICD-10 (conceptual), modifiers, NCCI awareness (nice-to-have)
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.