BPO Health Care and Insurance OperationsAnalyst

In this Role you will be Responsible For:
Process Insurance Claims timely and qualitatively
Meet & Exceed Production, Productivity and Quality goals
Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities
Analyze customer queries to provide timely response that are detailed and ordered in logical sequencing
Cognitive Skills include language, basic math skills, reasoning ability with excellent written and verbal communication skills
Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing
Continuous learning to ramp up on the knowledge curve to be the SME and to be compliant with any certification as required to perform the job
Be a team player and work seamlessly with other team members on meeting customer goals
Developing and maintaining a solid working knowledge of the insurance industry and of all products, services and processes performed by Claims function
Handle reporting duties as identified by the team manager