Operations Manager - Healthcare Claims

Job Name:

Repricing Analyst

Position Title: 

Manager

Band:

C1

Domain:

Healthcare 

Reporting to:

Senior Manager

Location/Site:

EXL India, Chennai

Overview:  The main objective of this position is to validate, calculate, and accurately report any overpaid amounts in the system. As a Repricing Analyst, you will be analyzing claims to determine the precise overpaid amount and recording the outcomes in the client/internal system. Your contribution to these tasks will help us maintain the accuracy and integrity of our client's financial records.

Qualifications: Any Graduate/ Postgraduate

Working Hours: 40 hours /week, Full Time Employee

Telecommuter/Internet requirements, if applicable: High Speed internet connection and Power back up (preferred)

Skills and abilities:

• Exp: 9-14 years
• Strong ability to lead, motivate, develop teams, setting clear expectations and managing team performance to achieve company goals.
• Ability to think long term and align team and business strategies with Organizational objectives
• Skilled at problem solving and identifying solutions quickly.
• Strong communication with stakeholders at all levels, including team members, upper management and clients
• Strong organizational skills to oversee multiple projects and initiatives simultaneously

Job Description:

• Lead, train and mentor staff members, ensuring high levels of engagements and productivity.
• Monitor and ensure excellent client service is always provided, addressing escalated client issues and resolving them in a timely manner.
• Analyze data, performance metrics and trends to make informed business decision.
• Strong interpersonal skills for working with cross functional teams and departments

Responsibilities:

• Oversee day to day operations and ensure the team functions smoothly.
• Conduct regular performance reviews, provide feedback and implement strategies for continuous improvement
• Set performance goals and track progress toward meeting them.
• Ensure the department meets or exceeds financial goals and identify opportunities for revenue growth.
• Build and maintain strong relationship with clients and key stakeholders.
• Manage risk by identifying potential threats to business operations and implementing preventive measures.
• Manage resource distribution effectively to meet the operational needs, make decisions about hiring, promotions and team restructuring as needed.
• Prepare and present regular reports to senior leadership on team performance, operational challenges and successes.
• Use data and analytics to support recommendations and strategic initiatives.
• Promptly respond to all the emails (Internal / External).
• Adhere to project protocols and instructions
• Provide insights to senior management and suggest improvement areas based on data analysis.
• Ensure service delivery of all programs with SLAs and Ops metrics
• Maintaining inventory report with quality and TAT.
• Maintaining the Team reports (Productivity, Quality and other reports as applicable) updated.
• Ensure compliance with all relevant regulations and policies.