Executives

Position Title, Responsibility Level

Associate

Function

Healthcare

Reports to

Assistant Manager

Permanent/ Temporary

Permanent

Span of Control

Individual Contributor

Location

Kochi, India

Basic Function

• Work Type - Back office
• Search for claims related documents in different systems, create a case, attach the documents to the cases created
• Determine if case can be resolved or must be forwarded to a Subject Matter Expert (SME)
• Once the case is received from SME, action cases as guided by the SME
• Generate letter and send it to the customer
  

Essential Functions

• Navigate through multiple system / applications for data gathering
• Proficiency with computer skills (navigating multiple systems and keyboarding)
• Understand the goals and standards to ensure that quality and productivity standards are met
• Accurate and timely updating of the database
• Meet the agreed upon KPIs as per the operational definitions and targets
• Participate in the User Acceptance Testing as needed
• 98% - 100% attendance during training/nesting period is required
• Tying speed 25-30 words/minute with 90% accuracy
• Must be flexible to work hours with Monthly work schedules changes
  

Primary Internal Interactions

• Actively participate in the team meetings, discussions and provide inputs
• Calibrate, Cooperate and support the team in pursuit of achieving and exceeding team goals
  

Primary External Interactions

• Email Communications
• Verbal Communication
  

Organizational Relationships

Reports To : Team Manager Supervises :

Skills

Technical Skills

• Working knowledge of MS office (Word, Excel and Power point) and Internet / Outlook
  

Process Specific Skills

• Advanced knowledge and ability to navigate CVSH-AETNA systems.
• Strong comprehension skills (Need screening during interview)
• US Healthcare knowledge is preferred but not mandatory
  

Soft Skills (Desired)

• Effective communication skills, both verbal and written, Aptitude &Analytical Anility
  

Soft Skills (Minimum)

• None
  

Education Requirements

Bachelor's degree with a minimum 15 years of education

Work Experience Requirements

Fresher's, resources right out of the college can be hired to 1 year experience

Annexure

Acknowledgement

(acknowledge that the information contained in this document is factual and complete)___________________________________ ___________________________________________ ____________________________Candidate Supervisor/Manager Date