SME | Insurance Claims
6 days ago
Job Description
KEY RESPONSIBILITIES OF THE SME
- Empower the Work: Create and facilitate Huddle Sessions to equip staff with fundamental skills and knowledge.
- Conduct BQM / Remedial training for the folks in nesting. Also conduct floor interventions for BQ teams.
- Strengthen relationships: Establish and maintain communication with clients and/or team members; understand needs, resolve issues, and meet expectations.
- Take the lead: Deliver new hire training for the business, ensuring to provide a good learning experience for new hires and equipping them with the relevant skill set to meet production goals from the first month post-nesting. Partner with quality and training manager to identify skill and knowledge gaps that lead to an unstable performance trend. Work with the training manager to prepare training content to run a BQ intervention for the business and cater learning via the update management process and new launches.
- Support the team with complex queries and fill out accurate reports.
- Support the team manager and ensure the team delivers against key service level metrics while creating value for clients by impacting business outcomes.
- Handle phone calls and transactions for the program.
- Supervise and coach learners in nesting & BQM type environments.
- Coach and give feedback to trainees to help them fulfill performance metrics.
Qualifications
- Minimum 24 months of insurance experience managing customer-facing accounts, preferably managing processes such as intake, scheduling, credentialing, medical bill reviews, and disabilities.
- Excellent data mining skills.
- Ability to think outside of traditional roles to evaluate business implications.
- Ability to interpret data, identify trends, and make suggestions for improvements.
- Strong verbal and written communication skills; able to communicate in a clear, constructive, and professional manner.
- Demonstrated leadership skills; able to take the lead in making improvements and resolving issues.
- Experience in blended operations which involve back-office work, making outbound, and receiving inbound calls.
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