Associate II - BPM

2 - 3 Years
4 Openings
Chennai, Kochi, Trivandrum

Role Proficiency:

A Voice Associate should under very minimal guidance be able to take customer support calls effectively and efficiently following the SOPs to complete the process and endeavour to resolve the issue or escalate to a more knowledgeable person to resolve in alignment with SLAs.rnA Data Associate should under very minimal guidance effectively and efficiently process the transactions assigned in a timely manner and ensure that quality of output and accuracy of information is maintained in alignment with SLAs

Outcomes:

Acts under very minimal guidance to achieve the following:

• Service Level Agreement (SLAs) specified by the client in terms of quality productivity and schedule should be managed to ensure 100% adherence.
• Data: Analyze information enter and verify data following the SOP to ensure completion of the task.
• Voice: Customer calls responses and any updates or edits to workflow based on after call work should be performed as per directions.
• Be aware of any clients processor product updates and ensure 100% compliance towards the same.
• Proficient in the process and assist other team members who are new to the process to ensure quick readiness of the team.
• Able to handle and manage higher complexity tasks.
Able to analyze processes and come up with ideas to automate them to increase operational efficiency.

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  Measures of Outcomes:

  • 100% Adherence to quality standards

  • Adherence to turnaround time for response and resolution

  • Completion of all mandatory training requirements

  • 100% adherence to process and standards

  • 100% adherence to SLAs where applicable

  • Number of issues fixed and tasks completed

  • Number of non-compliance issues with respect to SOP

  • Production readiness of new joiners within agreed timelines by providing guidance

  • Zero/No Client Escalations
  
  

  Outputs Expected:

  Processing Data:
  • Processing transactions assigned as per SOPs
  
  Handling calls Voice:
  • Handle customer support calls
    resolve issues and complete after-call work
  
  Production:
  • Take calls (voice) or process complex transactions (data)
  
  Quality:
  • Perform quality control for transactions processed by associates if required
  
  Reporting:
  • Create reports
    prepare spreadsheets of daily transactions data entry in software/tool

  • Report status of tasks assigned
    complying with project related reporting standards and process
  
  Productivity:
  • Completion of tasks with zero errors.

  • Take steps to improve performance based on coaching

  • Monitors progress of requests for support and ensures users and other interested parties are kept informed.
  
  Issue Resolution:
  • Identifies
    analyses and solves the incidents/transactions.

  • Address any problems with the supervisor /QA to ensure maximum productivity and efficiency.
  
  Training:
  • Attends one on one need-based domain/project/technical trainings as needed.

  • On time completion of all mandatory training requirements of the organization and customer.

  • Provide on floor training and one to one mentorship of new joiners.
  
  Escalation:
  • Escalate problems to appropriate individuals and support team based on established guidelines and procedures.
  
  Manage knowledge:
  • Consume project related documents
    share point libraries and client universities
  
  Communication:
  • Share status update to the respective stakeholders and within the team
  
  Collaboration:
  • Collaborate with different towers of delivery for quick resolution (within SLA); document learnings for self-reference.

  • Collaborate with other team members for timely resolution of errors

  • Assist new team members to understand the customer environment.
  
  Process Adherence:
  • Thorough understanding of organization and customer defined process; consult with mentor when in doubt. Adherence to defined processes.
    organization’ s policies and business conduct.
  
  

  Skill Examples:

  • Customer Focus: Focus on providing prompt and efficient service to customers goes out of the way to ensure that individual customer needs are met.

  • Attention to detail to ensure SOPs are followed and mistakes are not knowingly made

  • Team Work: Respect others and work well within the team.

  • Communication: Speak clearly and write in a clear and concise manner. Uses appropriate style and language for communication (Data)

  • Communication: Speaks in an accent neutral manner or with the accent required for the process with good vocabulary and grammar skills. Writes clearly (Voice)

  • Typing Speed with 15WPM and 80% accuracy

  • Make rule-based decisions and judgments based on guidance from Lead

  • Analytical ability to understand the larger picture of customer issues.

  • Ability to follow SOP documents and escalate the s with in the SLA defined.

  • Willingness and ability to learn new skills domain knowledge etc.

  • Sr. Process Associate Quality Auditor SME

  • Frontline resource - Voice/Backoffice Quality Auditors SME
  
  

  Knowledge Examples:

• Familiar with Windows Operating Systems MS Word MS Excel.
  • English comprehension – Reading writing and speaking

  • Domain knowledge based on process (healthcare banking investment F&A retail customer support etc)

  • Fair understanding of customer infrastructure ability to co-relate failures.

  • Familiarity with work allocation and intake functions

  • Experience level – 2 to 5 years
  
  
  Additional Comments:

  Role Summary: The Contract & Booklet Analyst is responsible for creating, reviewing, and auditing healthcare plan documents (Contracts and Booklets) while ensuring accuracy, compliance, and alignment with payer-side requirements. This role demands excellent benefit interpretation skills and strong communication. Key Responsibilities: Create, review, and maintain Contracts and Booklets (C&B) including: Cover Page, Table of Contents (TOC), How Your Plan Works (HYPW), Preventive Schedules, Contract/Booklet Schedule. Conduct audits of Contract & Booklet content against approved templates. Interpret and translate payer-side benefit configurations into member-facing documents. Support Testing and Member Appeal processes by sharing benefit highlights or booklet information. Collaborate effectively with benefit configuration, testing, and quality teams. Communicate benefit and contract details clearly to both technical and non-technical stakeholders. Ensure compliance with UST Core Values and client SLA commitments. Required Skills & Qualifications: Must be a Graduate 4+ years of experience in the US Healthcare domain (with focus on payer-side benefit configuration, contract, or booklet creation). Strong understanding of healthcare benefits (deductibles, copays, coinsurance, accumulators, preventive schedules). Excellent written and verbal communication skills – ability to coordinate with internal teams, clients, and stakeholders. Proficiency in MS Word, Excel, and documentation tools. Flexibility to work in Night Shift (5:30 PM – 2:30 AM IST) and 5 days in office. Preferred Qualifications: Prior experience in C&B creation projects or benefit audits. Knowledge of Medicare, Medicaid, and Commercial plan compliance requirements. Exposure to payer platforms (Facets, QNXT, Amisys, HealthRules, or similar). Experience in client communication, requirement gathering, and issue resolution. Key Competencies: Strong Communication & Presentation Skills Accuracy & Attention to Detail Analytical Thinking & Problem Solving Mentoring & Team Support Client-Focused Approach Alignment with UST Core Values (Humility, Humanity, Integrity)

Contract & Booklet creation,payer platforms,communication & presentation skills,Us Healthcare