Role Description
Role Proficiency:A Voice Associate Able to independently take customer support calls effectively and efficiently ;follow the SOPs to complete the process and endeavour to resolve the issue handle some escalated issues or escalate to a more knowledgeable person to resolve in alignment with SLAs and assists Lead I – BPM.rnA Data Associate should independently be able to effectively and efficiently process the transactions assigned in timely manner clarify complex transactions to others and ensure that quality of output and accuracy of information is maintained in alignment with SLAs and assists Lead I – BPM.
Outcomes
- Independently achieves the following; guiding other process associates and assists Lead 1 - BPM
- 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 follow 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.
- Address performance issues and improvement plans of team and self with supervisor.
- Expected to be proficient in the process and domain to ensure quality of transactions and guide the same to the process associates.
- Perform QA for production associates as an expert in the function and ensure completion within SLAs.
- Create reports on performance metrics for team to manage productivity.
- Understand the process and bring forward ideas and solutions to simplify and automate them to increase operational efficiency. Create automation solution and submit the same to Lead I for review.
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/tasks completed
- Number of non-compliance issues with respect to SOP
- Zero/No Client Escalations
- Number of high-quality RCA and QA output
- Daily/weekly performance reporting
- Mentors A1 and A2 resources on the processes
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)
Issue Resolution
- Address any problems with the supervisor/QA to ensure maximum productivity and efficiency.
- Identifies analyses and solves the incidents/transactions.
Productivity
- Proficient in the process assisting other team members who are new to the process as well to ensure quick readiness of the team.
- Take steps to improve performance based on coaching.
- Production readiness of new joiners within agreed timeline by providing guidance Actively participate in the team's or organization wide initiatives
- Able to handle and manage higher complexity tasks.
Adherence
- Be aware of any clients process or product updates and ensure 100% compliance towards the same.
- Adhere to release management process.
- Thorough understanding of organization and customer defined process. Consult with mentor when in doubt.
- Adherence to defined processes.
- Adhere to organization’ s policies and business conduct.
Reporting
- Create reports on specific SLAs/performance measures/KPIs
Stakeholder Management
- Guide the team in preparing status updates and keep management updated about the status.
Training
- Attends one on one need-based domain/project/technical trainings as needed.
- On time completion of all mandatory training requirements of organization and customer.
- Provide on floor training and one to one mentorship for new joiners.
Escalation
- Escalate problems to appropriate individuals/support team based on established guidelines and procedures.
Monitoring
- Monitor progress of requests for support and ensures users and other interested parties are kept informed.
Manage Knowledge
- Consume project related documents share point libraries and client universities
Mentoring
- Mentor and provide guidance to peers and junior associates.
- Assist new team members in understanding the customer environment.
Communication
- Status update to the respective stakeholders and within the team
Collaboration
- Collaborate with different towers of delivery for quick resolution (within SLA); document learning's for self-reference.
- Collaborate with other team members for timely resolution of errors.
Skill Examples
- Customer Focus: Focus on providing a 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
- Analytical approach: Makes systematic judgments based on information and relevant assumptions.
- Ability to follow SOP documents and escalate the s within the defined SLA Willingness and ability to learn new skills domain knowledge etc.
- Make rule based and discretionary decisions.
- Process Trainer/Sr. QA/Domain Expert/MIS Analyst
- Frontline resource - Voice/Backoffice Quality Auditors SME Domain Experts
Knowledge Examples
- Expertise with Windows Operating Systems MS Office tools
- English comprehension – Reading writing and speaking
- Domain knowledge based on process (healthcare banking investment F&A retail customer support etc)
- Familiarity with work allocation and intake functions
- Familiarity with quality control processes including pare to analysis and root cause analysis
- Knowledge on security policies and tools
- Good understanding of customer infrastructure ability to co-relate failures
- Experience level – 3 to 7 years
Additional Comments
Job Title: Provider Credentialing Associate Shift Timing: 5:30 PM - 2:30 AM IST (Night Shift) Work Model: 5 Days Working - Work from Office Experience: 5+ Years Domain: US Healthcare - Provider Credentialing Job Summary: We are seeking an experienced Associate to join our Provider Credentialing team within the US Healthcare domain. The ideal candidate will bring deep knowledge of the credentialing process, excellent communication skills, and the ability to thrive in a fast-paced, client-focused environment. Key Responsibilities: Manage end-to-end provider credentialing and re-credentialing processes. Review, verify, and validate provider information in compliance with regulatory and client-specific guidelines (CAQH, NPPES, DEA, etc.). Liaise with providers, insurance plans, and internal stakeholders to ensure timely credentialing. Maintain and update provider data in credentialing systems accurately. Track application status and proactively resolve delays or discrepancies. Ensure adherence to compliance standards (CMS, NCQA, URAC, HIPAA). Generate and review credentialing reports as required. Support audits and documentation for internal and external reviews. Contribute to continuous process improvement initiatives. Required Skills & Qualifications: Minimum 5 years of hands-on experience in US Healthcare domain preferably exp in Provider Credentialing. In-depth understanding of US healthcare regulations and payer requirements. Strong verbal and written communication skills; ability to interact professionally with providers and clients. Experience with credentialing software and databases (e.g., CAQH, PECOS). Attention to detail and strong analytical skills. Ability to work independently and manage multiple priorities. Preferred Attributes: Exposure to working with US based clients or stakeholders. Demonstrated problem-solving ability and a proactive mindset. High sense of accountability and alignment with UST values - Humility, Humanity, Integrity.
Skills
Us Healthcare,Credentialing software/Databases,Communication,Analytical
