AVP - Claims handling (US Healthcare)Selections HR Services Private Limited • Karnataka, India
AVP - Claims handling (US Healthcare)
Selections HR Services Private Limited • Karnataka, India
7 days ago
Job descriptionAct as the primary operations leader for client engagement, reviews, and performance governance. Present insights, solutions, and recommendations for business growth and value creation. Lead a span of 800+ FTE across multiple locations. Drive performance management, succession planning, training, and employee engagement. Ensure adherence to HIPAA, ISO, and internal audit / compliance requirements. Own SLA delivery, quality metrics, audits, and performance scorecards. 18–20+ years of experience in Healthcare BPM with 10–12+ years in US Healthcare Claims Operations . Proven experience managing large delivery teams and multimillion-dollar portfolios. Strong domain knowledge of the claims lifecycle and payer operations. Demonstrated expertise in transformation, automation, and service delivery excellence. Strong communicator, influential leader, and solution-oriented thinker.
About the Role
We are hiring an accomplished AVP – Claims Operations (US Healthcare) to lead and transform large-scale claims operations, elevate service delivery, and drive innovation across a major healthcare BPM setup.
The role oversees multi-location delivery teams, partners with global stakeholders, leads automation and analytics-driven transformation, and manages a portfolio of USD 10–20M. This is a high-impact leadership role reporting into the senior operations leadership team.
Key Responsibilities
Strategic & Operational Leadership
- Lead end-to-end US Healthcare Claims Operations to industry-leading standards.
- Manage large-scale back-office claims functions including PI, SIU, Rework, Enrollment, Coding, Product Build, etc.
- Drive automation, RPA, analytics, and transformation initiatives.
- Manage P&L, budgets, revenue optimization, cost control, and workforce planning.
Client & Stakeholder Management
People Leadership
Governance & Compliance
Ideal Candidate Profile
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