Platzhalter Bild

Area Manager-Claims Management-Medical Billing and Claims Processing bei exl Service.com (India) Private Limited

exl Service.com (India) Private Limited · Chennai, Indien · Hybrid

Microsoft Excel

CMS

Jetzt bewerben

Key Responsibilities:

  1. Strategic Coordination and Alignment
    1. Serve as the key liaison between POD Leader and Operations/Program Leaders to ensure alignment on client engagement, requirements, and escalation management.
    2. Align POD-level goals with program objectives and the broader business strategy.
    3. Partner with Program and POD Leaders for strategic planning, including forecasting performance, capacity planning, and staffing to meet revenue goals.
  2. Audit Life Cycle Management:
    1. Collaborate across functions to ensure effective service delivery throughout the audit lifecycle—from data management and selections to recovery.
    2. Review exceptions, analyze anomalies, and provide insights with appropriate narrative and resolution actions.
    3. Monitor audit KPIs, SLAs including volume, capacity, forecasting, audit completion, TATs, priority completions, and recovery & collection
  3. Client Engagement:
    1. Maintain dual accountability with Program Leaders for client-facing communications and engagement.
    2. Respond to adhoc client needs, compliance, and administrative requirements promptly.
    3. Ensure timely and appropriate client communication alongside Program Leaders.
  4. Analytics and Technology:
    1. Lead analytics initiatives in collaboration with Program Leaders for business intelligence and advanced reporting solutions.
    2. Drive technology initiatives to enhance operational efficiencies and work closely with Program Leaders on solutioning.
  5. Service Delivery Excellence & Operational Efficiency
    1. Conduct continuous 360-degree reviews of service delivery and identify improvement areas.
    2. Work with Program Leaders to uphold high standards and timely delivery of all reports to senior leadership.
    3. Identify revenue leakage and bottlenecks; collaborate cross-functionally to implement scalable solutions.
    4. Facilitate regular review meetings with Program and POD Leaders to discuss progress and insights.
    5. Present performance metrics, revenue trends, and risk assessments to senior management.
  6. Digital Transformation
    1. Collaborate with Digital Engineering and Tech teams to evaluate and implement automation and analytics tools aligned with business objectives.

Responsibilities

Manager - POD Operations: Key Responsibilities

Working Hours: 40 HOURS PER WEEK, FULL TIME EMPLOYEE.

Key Competencies:

  1. Strategic Thinking & Alignment
  2. Analytical & Data-Driven Decision Making
  3. Client Relationship Management
  4. Cross-Functional Collaboration
  5. Problem Solving & Escalation Management
  6. Process Improvement & Operational Excellence
  7. Leadership & Team Management

Strategic Coordination: Facilitate seamless alignment and collaboration between POD and Program operations to support overall business goals.

Audit Lifecycle Oversight: Manage the end-to-end audit process, ensuring timely, accurate, and compliant execution of audits.

Service Delivery Excellence: Drive continuous improvements in service quality to enhance client satisfaction and operational performance.

Client Relationship Management: Build and maintain strong client relationships, addressing their needs and resolving issues promptly.

Support Growth Initiatives: Partner with business development teams to identify and enable growth opportunities within POD operations.

Analytics and Technology Enablement: Lead adoption of data analytics and technology tools to improve decision-making and operational efficiency.

Compliance Management: Ensure all processes comply with regulatory requirements and internal policies, addressing any gaps proactively.

Stakeholder Engagement: Act as a bridge between key stakeholders, facilitating clear communication and collaboration.

Revenue Optimization: Identify and implement strategies to maximize revenue and profitability within POD operations.

Operational Efficiency: Continuously optimize workflows and processes to reduce costs, increase productivity, and meet performance targets.

Qualifications

  1. Bachelor’s degree in any or related field; MBA or relevant advanced degree preferred.
  2. Experience: Minimum of 10 years’ experience in US Healthcare and Payment Services LOB preferred.
  3. 5+ years of experience in operations management, preferably in audit lifecycle or service delivery domains.
  4. Proven experience in strategic planning, client engagement, and cross-functional team leadership.
  5. Strong analytical skills with proficiency in metrics tracking, reporting, and business intelligence tools.
  6. Excellent communication skills with client-facing experience.
  7. Ability to manage multiple stakeholders and complex escalations effectively.
  8. Experience with compliance standards (HIPAA, CMS) and quality assurance.
  9. Familiarity with digital transformation initiatives and technology-driven process improvements.

About Company

EXL is the indispensable partner for leading businesses in data-led industries such as insurance, banking and financial services, healthcare, retail and logistics. We bring a unique combination of data, advanced analytics, digital technology and industry expertise to help our clients turn data into insights, streamline operations, improve customer experience, and transform their business. Our partnerships with clients are built on a foundation of collaboration – and we’ve been chosen as a partner by nine of the top ten leading US insurance companies, nine of the top 20 global banks, and six of the top ten US health care payers. We function as one team to make your goals our goals, whether that’s unlocking the value of generative AI or embedding analytics into workflows that reduce risk or power your growth. Clients choose EXL as their transformation partner for many reasons. Our geographic diversity make talent all over the world instantly accessible. Digital accelerators enable unmatched speed-to-value, letting you realize results fast. It’s our people that truly set us apart, though, including the 1,500 data scientists we have dedicated to our generative AI practice. And our more than twenty years of experience in delivering business services, garnering stellar client references, and maintaining a solid balance sheet are reassuring to our C-suite clients. Find out for yourself why clients, employees, and analysts think we’re some of the best in the business. Contact us to see how we can help you achieve your goals.

Company

EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 54,000 employees spanning six continents. For more information, visit www.exlservice.com.


EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL’s Human Resources team, as well as our hiring managers.
Jetzt bewerben

Weitere Jobs

Firmenlogo

Principal Scientific Writer

Sanofi · Hyderabad,

Firmenlogo

Associate Project Specialist – Medical Communications

Sanofi · Hyderabad,

Firmenlogo

Team Lead – Medical Communications

Sanofi · Hyderabad,