SeniorExecutive

Job Description: Track process transactions and implement sampling methodology

Audit client clinical claims review functions per process guidelines

Providing event-based and frequency-based feedback to stakeholders

Communicate case consults to Quality Management team both internally and client level

Assisting operations in identifying training needs and process level issues that can help improve performance

Ensure that rebuttal process is followed. This includes calls with client supervisors and managers both on quality and operations side

Participate in monthly inter-rater reliability tests to ensure process calibration

Attend team meetings both internal and client level. This includes reporting quality trends and other client requested data, discussion of workflow, policies, procedures and initiatives

Brief new agents joining the process and explain how the quality function operates in the process

Assist with preparation of quarterly/monthly/annual quality reports

Establish effective rapport with clients and stakeholders

Responsibilities: Track process transactions and implement sampling methodology

Audit client clinical claims review functions per process guidelines

Providing event-based and frequency-based feedback to stakeholders

Communicate case consults to Quality Management team both internally and client level

Assisting operations in identifying training needs and process level issues that can help improve performance

Ensure that rebuttal process is followed. This includes calls with client supervisors and managers both on quality and operations side

Participate in monthly inter-rater reliability tests to ensure process calibration

Attend team meetings both internal and client level. This includes reporting quality trends and other client requested data, discussion of workflow, policies, procedures and initiatives

Brief new agents joining the process and explain how the quality function operates in the process

Assist with preparation of quarterly/monthly/annual quality reports

Establish effective rapport with clients and stakeholders

Qualifications: Eligibility

• No Attendance issues for 6 months (97% Reliability and QA Score of 97% & above)
• No Disciplinary Actions from the last 3 months
• With minimum of <3 years of Quality Assurance experience

• Must be willing to work from office 100%
  

Skillset

• Must be proficient in English oral and written communications
• Must have advance skills in reporting and story telling
• Must have intermediate to advance knowledge on Microsoft Application
• Must possess critical thinking and problem-solving skills

Must have extensive knowledge of the Life Insurance and Annuities industry/processes