Claims Senior Supervisor – International Healthcare

Location: CHSI, Bengaluru, India
Reporting to: Claims Manager / Associate Director
Role Level: Senior Supervisor
Experience Required: 8–12 years (International Healthcare Claims Operations)

Role Purpose

As a Claims Senior Supervisor, you will play a critical leadership role within the international healthcare claims operation. You will be responsible for day‑to‑day supervision of claims processing teams, ensuring accuracy, turnaround time, compliance, and customer satisfaction across international markets.

You will lead a team of Claims Analysts/Processors (typically 15–30 FTE), acting as the first line of leadership, performance management, and issue resolution. The role requires strong domain expertise, people leadership skills, and the ability to drive operational discipline and continuous improvement in a regulated environment.

Key Responsibilities

1. Operational Delivery

• Supervise end‑to‑end claims processing activities across international healthcare products.
• Ensure adherence to SOPs, turnaround time (TAT), quality, and productivity targets.
• Monitor daily work queues, volumes, and ageing; proactively manage backlogs and risks.
• Ensure accurate claim adjudication in line with policy terms, benefit structures, and regulatory requirements.
• Escalate complex, high‑risk, or high‑impact issues to management with clear analysis and recommendations.

2. Quality & Compliance

• Ensure compliance with internal controls, audit requirements, data privacy standards, and regulatory guidelines.
• Conduct regular quality reviews, identify error trends, and implement corrective actions.
• Support internal and external audits, responding to findings and driving closure of action items.
• Reinforce strong documentation and process adherence within the team.

3. People Leadership

• Lead, coach, and motivate a team of Claims Processors/Analysts.
• Set clear performance expectations and conduct regular performance reviews and feedback sessions.
• Identify training needs and support onboarding, upskilling, and cross‑training initiatives.
• Build a culture of accountability, collaboration, and continuous improvement.
• Support succession planning by developing future team leads and supervisors.

4. Performance Management & Reporting

• Track and analyse productivity, quality, SLA, and TAT metrics at individual and team levels.
• Prepare and present daily/weekly operational reports and dashboards.
• Use data to identify trends, root causes, and improvement opportunities.
• Drive action plans to address performance gaps and sustain improvements.

5. Process Improvement & Change Support

• Identify opportunities to improve process efficiency, accuracy, and customer experience.
• Participate in process improvement, automation, and standardisation initiatives.
• Support implementation of new products, processes, tools, and system changes.
• Act as a change champion, ensuring smooth adoption within the team.

6. Stakeholder Collaboration

• Work closely with Managers, Quality, Training, Technology, and Onshore Stakeholders.
• Provide timely updates on operational performance, risks, and dependencies.
• Support effective communication and coordination across teams and functions.

Your Profile

Experience

• 15+ years of experience in international healthcare claims operations.
• At least 10+ years in a Team Lead or Supervisory role managing claims teams.
• Strong understanding of international healthcare policies, benefit structures, and adjudication rules.
• Proven experience managing high‑volume, SLA‑driven operations.

Skills & Capabilities

• Strong working knowledge of claims adjudication, quality standards, and compliance requirements.
• Hands‑on experience with claims systems and workflow tools.
• Good analytical skills with the ability to interpret operational data and trends.
• Proficient in Excel and reporting tools.
• Effective communicator with the ability to provide clear guidance and feedback.
• Strong problem‑solving and decision‑making skills.
• Ability to manage multiple priorities in a fast‑paced environment.

Behavioural Attributes

• Results‑oriented with a strong sense of ownership and accountability.
• Calm under pressure and capable of managing operational challenges.
• Collaborative, approachable, and people‑focused.
• Open to change with a continuous improvement mindset.
• High integrity and commitment to quality and compliance.

Key Competencies

• Team leadership and people development
• Operational execution & discipline
• Quality and compliance focus
• Data‑driven performance management
• Problem solving and root‑cause analysis
• Stakeholder collaboration
• Adaptability and change support