Consulting Jobs in Noida, India (Now Hiring) — 1,290 open — Page 58

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