Reconciliation Team Lead

What You Do

• Oversee the Claims Reconciliation Team s daily activities, setting clear productivity and quality targets, and regularly reporting progress to the Manager and Heads.
• Generate comprehensive Monthly Management Reports detailing Reconciliation Status (both open and closed), including disputed and payable amounts, while emphasizing key insights and actionable recommendations.
• Design and implement process improvements not only within reconciliation but also across related functions where issues arise, such as adjudication mistakes, system glitches, unclear rejection reasons, timing, and technical errors.
• Lead coaching and feedback sessions with both internal and external stakeholders to align on reconciliation requirements.
• Organize ongoing training and development programs to boost team expertise and capabilities.
• Establish performance objectives and track team progress to maintain exceptional accuracy and efficiency in reconciliation.
• Create and execute strategies that optimize reconciliation workflows and enhance operational efficiency.
• Ensure all reconciliation activities strictly comply with internal policies, external regulations, and industry standards.
• Stay informed on relevant regulations and enforce compliance within the team.
• Provide direct feedback to our Claims Medical team to improve the overall process.
• Perform other ad hoc duties as neede

What You Bring

• Bachelor s degree preferred in Medical fields, Finance, Business Administration, Insurance, or related areas.
• At least 5 years of experience in claims reconciliation, finance, accounting, or similar fields.
• Demonstrated success in managing and resolving complex claims challenges.
• Excellent analytical and problem-solving abilities.
• High attention to detail and precision.
• Skilled in financial software and reconciliation tools.
• Strong communication and interpersonal skills.
• Proven ability to lead, inspire, and develop teams.
• Familiarity with applicable regulations and industry standards.
• Hybrid work option available based on business needs.