Assistant Manager

Key Responsibilities

Claims Adjudication & Escalation Management

• Manage accurate adjudication of US medical claims as per defined guidelines and policies
• Handle escalations, resolve issues, and ensure proper documentation
• Ensure compliance with insurance policies, procedures, and regulatory standards

Team Management & Leadership

• Provide coaching and feedback to team members to improve performance
• Support new hires and accelerate their learning curve
• Conduct regular performance reviews and manage team productivity
• Manage staffing to meet operational requirements and shrinkage targets
• Drive initiatives to reduce attrition and improve engagement

Performance & Quality Management

• Monitor transactions regularly and implement corrective actions
• Ensure achievement of all SLA/KPIs (quality, productivity, turnaround time)
• Identify opportunities for process improvement and implement enhancements
• Maintain high standards of work quality and accuracy

Stakeholder & Client Interaction

• Communicate proactively with internal and external stakeholders
• Build and maintain strong relationships with clients and business partners
• Handle client interactions at supervisory level when required

Reporting & Compliance

• Ensure timely and accurate reporting of internal and external metrics
• Support audits by collecting and providing required data
• Ensure adherence to internal policies, external regulations, and information security standards

Core Competencies

Data Gathering & Problem Solving

• Gather relevant data from multiple sources and identify key issues
• Generate and evaluate solutions to determine the most effective outcome

Business Awareness

• Understand business operations and contribute to initiatives that enhance competitive advantage

Customer Focus

• Deliver high-quality service by understanding and addressing customer needs

Teamwork & Collaboration

• Work collaboratively with teams and respect organizational priorities

Managing Self

• Plan, prioritize, and execute tasks efficiently to meet deadlines

Adaptability

• Remain effective in a dynamic, fast-changing work environment

Work Standards

• Maintain high personal performance and quality benchmarks

Required Skills & Qualifications

• Medical Graduated are preferred
• Strong knowledge of US Medical Insurance Claims, processes, and procedures
• Understanding of US geography and culture
• Familiarity with quality standards and compliance requirements
• Excellent problem-solving and analytical skills
• Strong organizational skills with high attention to detail
• Excellent English communication (written and verbal)
• Good business writing skills (grammatically and contextually accurate)
• Ability to work on desktop systems and relevant applications

Behavioral Skills

• Customer service orientation
• Quality-driven mindset
• Strong interpersonal and stakeholder management skills
• Empathy for coaching and team development

Additional Requirements

• Willingness to work in night shift and WFO
• Ensure consistent achievement of KPIs
• Proactive communication on daily operational issues
• Continuous focus on quality, productivity, and customer satisfaction

Key Responsibilities

Claims Adjudication & Escalation Management

• Manage accurate adjudication of US medical claims as per defined guidelines and policies
• Handle escalations, resolve issues, and ensure proper documentation
• Ensure compliance with insurance policies, procedures, and regulatory standards

Team Management & Leadership

• Provide coaching and feedback to team members to improve performance
• Support new hires and accelerate their learning curve
• Conduct regular performance reviews and manage team productivity
• Manage staffing to meet operational requirements and shrinkage targets
• Drive initiatives to reduce attrition and improve engagement

Performance & Quality Management

• Monitor transactions regularly and implement corrective actions
• Ensure achievement of all SLA/KPIs (quality, productivity, turnaround time)
• Identify opportunities for process improvement and implement enhancements
• Maintain high standards of work quality and accuracy

Stakeholder & Client Interaction

• Communicate proactively with internal and external stakeholders
• Build and maintain strong relationships with clients and business partners
• Handle client interactions at supervisory level when required

Reporting & Compliance

• Ensure timely and accurate reporting of internal and external metrics
• Support audits by collecting and providing required data
• Ensure adherence to internal policies, external regulations, and information security standards

Core Competencies

Data Gathering & Problem Solving

• Gather relevant data from multiple sources and identify key issues
• Generate and evaluate solutions to determine the most effective outcome

Business Awareness

• Understand business operations and contribute to initiatives that enhance competitive advantage

Customer Focus

• Deliver high-quality service by understanding and addressing customer needs

Teamwork & Collaboration

• Work collaboratively with teams and respect organizational priorities

Managing Self

• Plan, prioritize, and execute tasks efficiently to meet deadlines

Adaptability

• Remain effective in a dynamic, fast-changing work environment

Work Standards

• Maintain high personal performance and quality benchmarks

Required Skills & Qualifications

• Medical Graduated are preferred
• Strong knowledge of US Medical Insurance Claims, processes, and procedures
• Understanding of US geography and culture
• Familiarity with quality standards and compliance requirements
• Excellent problem-solving and analytical skills
• Strong organizational skills with high attention to detail
• Excellent English communication (written and verbal)
• Good business writing skills (grammatically and contextually accurate)
• Ability to work on desktop systems and relevant applications

Behavioral Skills

• Customer service orientation
• Quality-driven mindset
• Strong interpersonal and stakeholder management skills
• Empathy for coaching and team development

Additional Requirements

• Willingness to work in night shift and WFO
• Ensure consistent achievement of KPIs
• Proactive communication on daily operational issues
• Continuous focus on quality, productivity, and customer satisfaction

Required Skills & Qualifications

• Medical Graduated are preferred
• Strong knowledge of US Medical Insurance Claims, processes, and procedures
• Understanding of US geography and culture