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Insurance Claims Specialist
1 week ago
Job Overview:
We are seeking a skilled Insurance Claims Specialist to join our team at Sutherland.
About the Role:
- This is an excellent opportunity for a motivated individual to take on a leadership role and make a real impact in our customer service operations.
Your Key Responsibilities:
- You will be responsible for empowering our staff with the necessary skills and knowledge to deliver exceptional customer service.
- You will conduct training sessions to equip staff with the required skills and knowledge, including BQM and remedial training.
- You will establish and maintain strong relationships with clients and team members, ensuring their needs are met and expectations exceeded.
- You will lead new hire training and ensure that new hires have a good learning experience and are equipped with the relevant skill set to meet production goals.
- You will support the team with complex queries and provide accurate reports.
- You will work closely with the team manager to ensure the team delivers against key service level metrics and creates value for clients by impacting business outcomes.
- You will handle phone calls and transactions for the program.
- You will supervise and coach learners in nesting and BQM type environments.
- You will coach and give feedback to trainees to help them fulfill performance metrics.
Required Skills and Qualifications:
- You must have minimum 24 months of insurance experience managing customer-facing accounts, preferably managing processes such as intake, scheduling, credentialing, medical bill reviews, and disabilities.
- You should have excellent data mining skills.
- You should be able to think outside of traditional roles to evaluate business implications.
- You should be able to interpret data, identify trends, and make suggestions for improvements.
- You should have strong verbal and written communication skills; able to communicate in a clear, constructive, and professional manner.
- You should have demonstrated leadership skills; able to take the lead in making improvements and resolving issues.
- You should have experience in blended operations which involve back-office work, making outbound, and receiving inbound calls.
