Executives

15 years

0 Lacs

Posted:1 day ago| Platform: Linkedin logo

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Work Mode

On-site

Job Type

Full Time

Job Description

Position

TitleExecutive, WC EDM Support

Function, Responsibility Level

Operations, Executive

Reports to

Assistant Manager

Span of Control

Nil

Location

Pune

Permanent/ Temporary

Permanent

As an associate / Sr. Associate in Claims Processing, your role is vital in ensuring accurate claim resolution in a dynamic, fast-paced environment that prioritizes exceptional customer service. This position requires a responsible for timely and accurate searching for correct details for exception documents and updated it. Associate would also need to liaise with claims handlers on need basis.

Essential Functions

  • Ensure that the process transactions are processed as per Desktop procedures
  • Ensure that the assigned targets are met in accordance with SLA and Internal standards
  • Ensure that the quality of transaction is in compliance with predefined parameters as defined by Process Excellence
  • Ensure adherence to established attendance schedules
  • Managing calendars and e-mails

Performance parameters

  • Productivity
  • Quality / Accuracy
  • Attendance
  • Schedule Adherence
Any other essential function that may occur from time to time as directed by the Supervisor

Primary Internal Interactions

  • AM for the purpose of reporting performance, escalation handling, clarifying concerns, and seeking feedback and support.
  • Manager for the purpose of settling issues left unresolved by the AM and monthly evaluation of performance
  • CCEs (Team Members) for the purpose of seeking cooperation & clarification on process-related matters & providing assistance and support when required
  • Subject Matter Expert for the purpose of work thread related issues and escalated transactions
  • QCA for the purpose of feedback and audit
  • Trainers for the purpose of Pre-process and Process training

Primary External Interactions

  • Escalation teams at the client end for the purpose of seeking clarifications & answering queries
  • SME / Trainers at the client end for training

Organizational Relationships

Reports To:

Assistant Manager

Supervises :

Nil

Skills

Technical Skills

  • Good Computer navigation skills
  • Good keyboarding speed
  • MS Office proficiency

Process Specific Skills

  • Knowledge about the US Workers’ Comp. Insurance industry
  • Knowledge about US Culture

Soft Skills (Minimum)

  • Good written skills
  • Customer Service Focus
  • Team work/ Managing Self / Adaptability
  • Data gathering ability/ Eye for detail

Soft Skills (Desired)

  • Self disciplined and result oriented
  • Ability to multi task

Education Requirements

Graduation (any stream) or diploma with a minimum of 15 years of education.

Work Experience Requirements

0 to 6 year of professional experience in data entry with Insurance industry. Familiarity with workers’ compensation insurance or health insurance industry required. Experience in handling insurance claims will be added advantage along with knowledge of US Healthcare system.

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Business Process Management / Analytics

New York

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