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Job Description:

Job Description – Disability Claims Processing

Role Description

Person would be responsible for Indexing and Claims. Ability to understand Claims receipts and Index accurately followed by Accurate Claims setup and adjudication is required. Process may involve Indexing and Claims to be done separately by different pool of associates

Education/Experience

• Minimum – Graduate
• 1-2 years of customer service experience in International BPOs (non-voice)
• Candidates to have worked in a previous North American Insurance company with Healthcare knowledge/ experience
• 1-2 years of industry experience (annuity, mutual funds, banking, or insurance) preferably in Claims adjudication

Skills/Knowledge

• Good written and verbal communication skills—Ability to understand conventional English names is critical
• Good mathematical aptitude
• Good commitment to customer service and quality

• Good research and follow-up skills
• Typing skills of 25-30 words per minute
• Proven ability to work independently and in a team environment
• Ability to comprehend French documents is desirable

Responsibilities

• Processes customer claims in a timely and accurate manner
• Meets established quality control measures
• Meets individual productivity requirements
• Communicates with customers through written and oral correspondence
• Provides follow up on requests that cannot be immediately resolved
• Builds relationships with staff from other departments to ensure queries are responded to in a timely manner
• Escalates issues to management when needed
• Works with management to set daily priorities to ensure prompt and efficient service
• Maintains flexibility in a high speed, demanding team environment
• Identifies process improvements to increase efficiencies and streamline processes
• Actively participates in departmental team meetings and other open forums
• Assists with department projects and initiatives as needed
• Soliciting and compiling information and data related to processing activities
• Using PC application and functions such as Excel and Word to update and load data sets
• Working with mainframe applications and Electronic Response Messaging
• Creating and monitoring the processing checklists and calendars
• Meeting and exceeding client defined service level metrics on timeliness and accuracy

Job Competencies

Please list 4-6 job competencies that can be used to identify behavioral-based interview questions.

• Rule based decision making ability
• Accurate Data entry skills
• Good typing skills/speed
• Familiarity with review of Imaged documents – Can interpret/understand various formats

Job Category:

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