Claims Adjudication - Team Lead Claims - BF - 376-2597 - JR151923

Team Lead – Claims

Requirement Type

Full-Time Employee

Job Location

Bangalore

Requirement Level

Team Leader

Hiring Manager

Manager

Primary Skill

People’s Manager

Business Operations

Claims

Business

Business Operations

Skill Category

Generic

ABOUT ELEVANCE HEALTH

Elevance Health is a leading health company in America dedicated to improving lives and communities and making healthcare simpler.  It is the largest managed health care company in the Blue Cross Blue Shield (BCBS) Association serving more than 45 million lives across 14 states.

A regular in Fortune 500 list, Elevance Health ranked 20 in 2022. Gail Boudreaux, President and CEO of Elevance Health has been a consistent name in the Fortune list of most powerful women and currently holds 4th rank on this list.

ABOUT CARELON

Carelon Global Solutions (CGS) is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare system.

Previously known as Legato Health Technologies, Carelon Global Solutions (hereinafter, CGS) underwent a name change and joined the Carelon family of brands in January 2023, as a fully owned subsidiary of Elevance Health (Previously Anthem Inc.). CGS brings together a global team of like-minded innovators who manage and optimize operational processes for health plans as well as providers.

Our brightest minds housed across our global headquarters in Indianapolis as well as Bengaluru, Hyderabad and Gurugram in India, Manila in the Philippines, Limerick in Ireland and San Juan in Puerto Rico bring with them innovative capabilities and an unmatched depth of experience. This global team uniquely positions CGS to enable scalable, next-generation platforms and specialized digital tools that make healthcare operations more practical, effective, and efficient.

OUR MISSION & VALUES

Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting More.
Our Values: Leadership | Community | Integrity | Agility | Diversity

JOB POSITION

Carelon Global Solutions India is seeking a highly creative and meticulous Team Lead, who will be responsible for all business delivery & performance as per set SLA parameters.  The incumbent will report to Associate Manager – Business operations and must understand the business delivery, metrics with multiple stakeholders; brief and deliver all in-house process delivery & requirements, apart from coordinating with onshore partners as and when required.

JOB RESPONSIBILITY

Team Lead – Claims(Business Operations) will be responsible for the following:

• Drive a Team of 18-20 Associates to meet the Productivity and Accuracy goals
• Conducted Daily Team Huddles and ensure all process updates are cascaded timely
• Connect with Assistant Manager – Claims to share Weekly progress of the Team Key metrics
• Drive the CIW E2E and CIW Adoption above 95%
• Perform Daily RCA with associates and create mitigation plans on accuracy improvement and stability by providing Coaching and Feedback to the associates
• Connect with Elevance Stakeholder for completing due-diligence across all metrics
• Drive Performance Guarantee Metrics in terms of Claims Timeliness and accuracy metrics
• Pend List management
• Perform Monthly 1*1 with all associates with to help associates elevate the performance and show career growth path and ensuring retention management is done.
• Ensure organizational initiatives and projects are successfully communicated to employees and stakeholders
• Participate in Carelon Initiatives and provide ideations and innovations to increase process efficiency
• Create and implement monthly deadlines, project goals, expectations and workflows to ensure a smooth production process with on-time delivery

QUALIFICATION

• Bachelors’ or Masters’ degree in fine arts/ design
• Non-BTech preferably

EXPERIENCE

• 6+ years of overall experience including extra-ordinary internal personal skills, communication skills
• Healthcare / Claims Experience will be required (added advantage

SKILLS AND COMPETENCIES

• Responsible for serving as the operations point of contact in for day to day operations, including but not limited to, facilitating issue resolution, meeting goals and targets Primary duties may include, but are not limited to
• TL should be able to analyze inventory and plan and deploy work force accordingly
• Should track and report performance data to leaders and counter partners from onshore
• Manage new hire associates and plan for their training and refresher training as needed
• Excellent Data management and Data presentation skills(MS Office – Minimum)
• Should be able to manage and track aspiration of team and help them develop
• Conduct one on one on monthly basis and provide performance data
• Push for innovation and enhancements
• Attend onshore/offshore with different business partners and share /deliver findings /asks.
• Agile & Solution centric
• Inclusive
• Flexible to work in any shifts/Work from office

THE CARELON PROMISE

Aligning with our brand belief of ‘limitless minds are our biggest asset’, we offer a world of limitless opportunities to our associates.

It is our strong belief that one is committed to a role when it is not just what the role entails, but also what lies in its periphery that completes the value circle for an associate.

This world of limitless opportunities thrives in an environment that fosters growth and well-being, and gives you purpose and the feeling of belonging.

LIFE @ CARELON

• Extensive focus on learning and development
• An inspiring culture built on innovation, creativity, and freedom
• Holistic well-being
• Comprehensive range of rewards and recognitions
• Competitive health and medical insurance coverage
• Best-in-class amenities and workspaces
• Policies designed with associates at the center

EQUAL OPPORTUNITY EMPLOYER

Carelon is committed to a diverse and inclusive workplace and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.

Reasonable Accommodation

Our inclusive culture empowers Carelon to deliver the best results for our customers. We not only celebrate the diversity of our workforce, but we also celebrate the diverse ways we work.

If you have a disability and need accommodation such as an interpreter or a different interview format, please ask for the Reasonable Accommodation Request Form.

Disclaimer: Offered designation titles differ*