Address Responsibilities:
Review and summarize applicant's medical information such as Attending Physician Statements, lab reports, paramed exams, and/or other related underwriting information consistent with the company's standards. Provide clear file documentation to support the onshore underwriting. Consult available resources including technical documentation, updates, co-workers, and trainers to perform daily task and meet performance targets as per training plan.
Takes ownership of individual production results to increase work credit consistently to achieve high results, thus contributing to department efficiency results. Identify and implement key projects in the process which would result into significant improvement. Improve efficiencies by submitting Operational Excellence ideas.
Qualifications:
This role involves rotational shifts including night shifts.
Review and summarize applicant's medical information such as Attending Physician Statements, lab reports, paramed exams, and/or other related underwriting information consistent with the company's standards. Provide clear file documentation to support the onshore underwriting. Consult available resources including technical documentation, updates, co-workers, and trainers to perform daily task and meet performance targets as per training plan.
Effectively and efficiently educate new and experienced employees on procedures and concepts and how to use available resources. Self-learning and knowledge enhancement and hands on day-to-day operational updates. Provide training, mentoring, and providing feedback to staff and management regarding training and learning. Provide quality customer service and build relationships by providing timely and accurate responses using research and resources to support question/problem resolutions. Drive change, growth, and profitability through new business tools. Identify & take the lead on special projects, Automations (i.e., RPA, AI, ML) as needed to help support departmental initiatives which would result into significant improvement. Builds relationships to expand networking opportunities. Keep training material and curriculum current and accurate to ensure meet learner’s needs.
Follow the corporate and business unit design standards to prepare materials as well as to identify and analyze the learning needs (TNI) of staff to meet customer expectations and internal service standards. Identifying the problems in specific/designated areas towards performance or procedural and working towards resolving those problems. Mentoring, Query support to new staff and make suggestions for improvement in procedures/processes. Improve personal effectiveness that positively impacts work, environment, and enhancement of skills. Handling extra responsibilities like reviews, performance tracking, generating reports and team bonding events
Training and on floor support for queries resolution. Ensuring all training KPIs and SLAs are met. Responsible for monthly connect with stakeholders to discuss the training progress, key activities, and new interventions. Conducting monthly process knowledge test for respective processes. Uses in depth knowledge of procedures to work efficiently through complex situations.
Takes ownership of individual production results to increase work credit consistently to achieve high results, thus contributing to department efficiency results. Identify and implement key projects in the process which would result into significant improvement. Improve efficiencies by submitting Operational Excellence ideas.
Qualifications:
Bachelor's / Master's degree in medicine preferred (MBBS, BAMS, BHMS etc.), Minimum of 2-3 years’ experience in back office, domain knowledge of Life and Health Insurance (Individual & Group Insurance), Typing test – 35-40 Wpm (Numeric), 99% accuracy, Good hands on knowledge of Excel, Excellent written and verbal communication skills, Insurance Domain knowledge (Domestic / Abroad – Health/ Life/ Disability /Dental claim processing experience Preferred), MS Office Proficient. Decision making skill, Problem solving, Good analytical skill. Domain knowledge of Life and Health Insurance (Individual & Group Insurance), Medical coding related certification and experience will be an addon.
Bachelor’s degree or equivalent –16-17.5yrs of Formal Education from recognized and accredited University. Bachelor's / master’s degree in medicine would be preferred (MBBS, BAMS, BHMS, etc.).
- Minimum of 2-3 years’ experience in back office. Insurance -Domestic Insurers / abroad, experience in Claims processing of Health Insurance / Life and disability claims/ Underwriting experience preferred.
- Knowledge of ICD-10 & CPT coding with CPC certification will be an added advantage.
Good MS Office, Good written and verbal communication skills.
