Basic Function

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 payment of Vendor payment, sending letters and other additional task to assist the claim handlers. Associate would also need to liaise with claims handlers on need basis.

Key

Responsibilities:

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  Create Correspondence and send Letters using the Email process to insured, claimant and service provider as per the process requirements
  
  
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  Create activity and tasks for reviews before sending the letters
  
  
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  Review and research payments information before issuing the payment
  
  
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  Manage complex claims processing functions, including process vendor payment
  
  
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  Utilize related systems and technology proficiently to streamline processes.
  
  
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  Evaluate the impact of new releases, procedures, and suggestions.
  
  
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  Identify and address system errors, program malfunctions, workflow inefficiencies, or processing improvements by liaising with team leaders or supervisors.
  
  
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  Assist quality auditors as required and undertake additional responsibilities as assigned.
  
  
• Communicate with handler for any clarification/authorization, if required

Performance Parameters

• Productivity
• Quality
• Attendance
• Schedule Adherence

Any other essential function that may occur from time to time as directed by the Supervisor.

Primary Internal Interactions

• Subject Matter Expert for the purpose of process training, ramp, floor support, and any process-related query
• QCA for the purpose of audit feedback
• 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.

Skills

Technical Skills

• Good computer navigation skills
• Good keyboarding speed (25 W.P.M.)
• Good knowledge of the complete MS Office suite

Process Specific Skills

• Knowledge of US P&C insurance

Soft skills (Minimum)

• Communication skills (English) -Should be able to speak, read, interpret business documents & write business emails.
• Escalate issues if required.
• Teamwork/ Managing Self / Adaptability
• Ability to work successfully in a production driven environment.
• Adaptability to change.
• Ability to work on routine/standardized transactions

Soft Skills (Desired)

• Self-disciplined and result oriented.
• Ability to multitask.
• Ability to work effectively as part of a team.
• Open to work extra time as per business requirements.

Education Requirements

Graduation or diploma from a college or university with a minimum of fifteen (15) years of education

Work Experience Requirements

• Minimum six months of work experience in a related field is required.
• Experience in BPO (Claims transaction processing) or US P&C Insurance industry experience shall be preferred.
• Fresher college graduates can be considered.

Skills: claims handling

Experience: 0.00-0.00 Years