Position Summary
The Team Lead – Claims Verification is responsible for managing end-to-end verification operations, primarily for Workers’ Compensation and No-Fault cases, while also supporting lien and other case types as required. The role ensures accuracy, compliance, and timely processing of all cases prior to billing, while driving team performance, accountability, and process discipline across the function.
Key Responsibilities
- Lead daily verification operations, including structured work allocation based on priority, volume, and team capacity
- Ensure all new and pending cases are processed within defined timelines to avoid backlog and revenue impact
- Maintain strict adherence to SOPs, payer-specific requirements, and internal compliance standards
- Manage escalations and complex cases, ensuring proper routing, ownership, and closure
- Monitor and drive resolution of aged cases through consistent follow-ups and accountability tracking
- Conduct regular one-on-ones to address performance gaps, provide feedback, and support team development
- Oversee QA function, including audit quality, consistency, and alignment with defined standards
- Review QA outputs, validate findings, and ensure proper documentation of errors and corrective actions
- Track daily productivity, KPIs, and reporting accuracy with full visibility across the team
- Own operational reporting, including daily dashboards and monthly performance reviews
- Maintain and continuously improve claims verification SOPs and workflows
- Drive daily/weekly huddles to ensure alignment, execution clarity, and issue resolution
- Act as the primary coordination point between verification, QA, billing, and other internal stakeholders
- Enforce discipline around schedules, attendance, and policy adherence; manage performance through structured corrective actions
Requirements
- 3–5+ years of experience in Claims Verification within US healthcare (Workers’ Compensation and/or No-Fault preferred)
- Prior experience in a team lead or supervisory role managing verification teams
- Strong understanding of eligibility, benefits verification, authorization workflows, and payer requirements
- Hands-on experience with US portals, clearinghouses, and verification tools
- Strong grip on SOP-driven environments with a focus on accuracy and compliance
- Proven ability to manage KPIs, reporting, and team performance in a high-volume setup
- Strong communication, ownership, and problem-solving skills
- Ability to handle pressure, manage escalations, and maintain operational control
What We’re Looking For
- Someone who can bring structure, not just manage tasks
- Strong ownership mindset with the ability to drive outcomes, not just activity
- Detail-oriented with zero tolerance for verification errors that impact billing
- Comfortable working in a fast-paced, performance-driven environment
- Ability to build and scale a disciplined verification function
Why Join Us?
- Get a chance to contribute and get recognition from Day 1.
- Work 5 days a week (Enjoy work-life balance).
- Modern work environment.
- A friendly, Supportive, Professional and achievement-oriented management team.
- Competitive Salary and Benefits, professionally run HR team.
- An opportunity to learn new things every day.
Perks & Benefits:
- Market Competitive Salary.
- Fuel Allowance.
- Family Health Insurance (OPD & IPD)
- Provident Fund.
- Paid Leaves. EOBI.
- Public Holiday Allowance.
- Employee Referral Bonus.
- Annual Salary Reviews.
