Senior Customer Care Executive

Firstsource Solutions is a leading provider of customized Business Process Management (BPM) services. Firstsource specialises in helping customers stay ahead of the curve through transformational solutions in order to reimagine business processes and deliver increased efficiency, deeper insights and superior outcomes. We are trusted brand custodians and long-term partners to 100+ leading brands with presence in the US, UK, Philippines and India. Our rightshore delivery model offers solutions covering complete customer lifecycle across Healthcare, Telecommunications & Media and Banking, Financial Services & Insurance verticals. Our clientele includes Fortune 500 and FTSE 100 companies.

Job Overview: A claims examiner needs to analyse multiple documents / contracts and decide to pay / deny the claim submitted by member or providers with respect to client specifications. The claims examiner should also route the claim to different department or provider / member for any missing information that required for claims adjudication. The claims needs to be completed adhering to required TAT and quality SLA.

Key Roles and Responsibilities: • In-depth Knowledge and Experience in Claims Processing. • Should have Excellent Analytical skills to review claims based on rules and workflows. • Need good comprehension skills to adjudicate claims as per Policies and Procedures. • Should be a complete team player Key Performance Indicators: • Ensuring that the key Service Level Agreements are met consistently without any exceptions. • Need to achieve set Production goals. • Adherence to departmental and company rules and regulations.

Reporting Structure: Sr Executive – Team Leader – Manger Operations. Success Profile: Qualification & Experience: Experience of 1+ year as an Claims Adjudicator. Graduation is a must in any stream of Education Good Comprehension skills. Typing speed of > 6000 characters per min