Job Description

Location(s)

• Posting Location: Noida, India

CountryIndiaWorking ScheduleFull-TimeWork ArrangementHybridRelocation Assistance AvailableNoPosted Date02-Jan-2024Job ID3243Description and RequirementsEssential Functions:? Analyze, validate and process transactions as per Desktop procedures (L3 & L4)
? Analyze and research all discrepancies
? Research & Investigate and resolve outstanding items
? Determine eligibility, entitlement and applicable plan provisions while meeting timeliness goals
? Clear and accurate written and verbal communication (Mix of scripted/unscripted) with employee, employer & stateside
resources by email and outgoing calls
? Establish action plans for each file to bring claims to resolution
? Utilize internal and external specialty resources to maximize impact on each claim file
? Use PC programs to increase productivity and performance
? Ensure that the assigned targets are met in accordance with SLA, Performance Guarantee and Internal standards
? Ensure that the quality of transaction is in compliance with predefined parameters as defined by Process Excellence
? Work as a team member to meet office goals to obtain disabilitys vision while demonstrating core values and
meeting key measures
? Ensure adherence to established attendance schedules
? Close visual activity - viewing a computer terminal and extensive readingAny other essential function that may occur from time to time as directed by the Supervisor.Technical Skills:? Good computer navigation skills
? Good keyboarding speed
? Good knowledge of complete MS Office suiteProcess Specific Skills:? Knowledge about the Insurance industry in US
? Knowledge about US Culture
? Knowledge of Insurance principlesSoft skills (Mandatory / Desired):Communication skills - should be able to read, interpret
business documents. Good verbal/written communication
? Proficiency in English - Spoken and Written
? Analytical and interpersonal skills
? Escalate issues if required
? Data gathering ability/ Eye for detail
? Team work/ Managing Self / Adaptability
? Ability to work successfully in production driven
environment
? Adaptability to change
? Ability to work on routine/standardized transactions
Desired:
? Self disciplined and result oriented
? Ability to multi task
? Ability to work effectively as part of a team
? Knowledge of Medical Terminology (preferred but not
compulsory)
Preferred:
? Claims, specifically disability, preferred
? Working knowledge of FMLA/Disability/Leave procedures
preferred
? Knowledge of system applications preferredEducation:
Graduate with at least 15 years of education.Work Experience Requirements:
Minimum 3-4 years of experience in a transactional, blended process of insurance or related industry with
relevant experience of working in a business environment (preferred but not compulsory)

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