Claims Representative, Operations
公司概述和文化 EXL （纳斯达克：EXLS）是一个全球分析和数字解决方案公司，与客户合作以改善业务成果并解锁增长。通过将深层领域专业知识与强大的数据，强大分析，云和人工智能结合在一起，我们为包括保险，医疗保健，银行和金融服务，媒体等行业的世界领先企业创建敏捷可扩展的解决方案并执行复杂运营。EXL 建立在创新，协作，卓越性，诚信和完整性的核心价值观上，重点是从数据中创造更快的决策和转型操作模式的价值。总部位于纽约，我们的团队拥有超过40,000名员工，遍布六大洲的50多个办事处。获取信息请访问 www.exlservice.com.过去20年，EXL 一直作为战略合作伙伴，并获得了奖项，帮助客户解决数字化转型，改善客户体验，简化业务运营，将产品更快地推向市场，提高公司财务，建立模型以更快地符合新规范，将数据量转换为商业机会，创造新的增长渠道和更好地适应变革等业务挑战。该企业在四个业务部门内开展业务：职位名称：索赔代表，运营简短职位描述：本工作的任务是迅速分析政策文件以确定和支付正确的保险死亡福利和受益者以及处理与死亡福利有关的接入电话。责任：·负责识别，调查，评估，获取和利用需要准确和客观地裁定索赔的关键信息。·口头沟通和与外部客户通信传递索赔申请要求。·处理索赔询问及处理多个产品线上。· 文件所有要求明确和简洁，并完成后续工作。· 确定公司可能存在风险的领域，包括潜在欺诈。· 对所有收到的文件进行适当和完整分析，并确定索赔是否可支付。如果是这样的话，计算福利金额，并作为首批批准支付。· 在解决索赔裁决问题和调控升级过程中的第一步。· 可能是回应。
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Company Overview and Culture EXL (NASDAQ: EXLS) is a global analytics and digital solutions company that partners with clients to improve business outcomes and unlock growth. Bringing together deep domain expertise with robust data, powerful analytics, cloud, and AI, we create agile, scalable solutions and execute complex operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media, and retail, among others. Focused on creating value from data for driving faster decision-making and transforming operating models, EXL was founded on the core values of innovation, collaboration, excellence, integrity and respect. Headquartered in New York, our team is over 40,000 strong, with more than 50 offices spanning six continents. For information, visit www.exlservice.com.
For the past 20 years, EXL has worked as a strategic partner and won awards in its approach to helping its clients solve business challenges such as digital transformation, improving customer experience, streamlining business operations, taking products to market faster, improving corporate finance, building models to become compliant more quickly with new regulations, turning volumes of data into business opportunities, creating new channels for growth and better adapting to change. The business operates within four business units: Insurance, Health, Analytics, and Emerging businesses.
Job Title:Claims Representative, Operations
Brief Job Description:
The mission of this job is to promptly analyze policy files to determine and pay correct policy death benefits and beneficiaries and to handle incoming calls related to the death benefits.
Responsibilities:
- Accountable for identifying, investigating, evaluating, obtaining and utilizing critical information required to accurately and objectively adjudicate claims.
- Verbally communicate and correspond with outside customers to convey claim filing requirements.
- Handles claim inquiries and processing on multiple product lines.
- Documents all calls clearly and concisely and completes follow-up work.
- Identify areas of potential risk for the company, including potential fraud.
- Analyze all incoming documents for appropriateness and completeness, and determine whether claim is payable. If so, calculate benefit amounts and serve as 1st approver for payments.
- Serves as the first step in resolving claims adjudication issues and in the call escalation process.
- May be responsible for incoming and outgoing calls to claimants, Power’s of Attorney, facilities and other person’s or entities involved in the adjudication of a claim.
- Ensure all tax information is correctly reported.
- Maintain claim file with proper level of documentation.
- Answer customer inquiries.
- Maintain claim inventories within departmental, contractual, and regulatory guidelines.
Basic Qualifications:
- Death claims processing for life and/or annuity contracts preferred
- Two-year college degree or equivalent experience in a financial institution operations department, customer service, or annuity product experience.
- Knowledgeable in life or annuity products and death claim processing
- Must have sharp attention to detail and ability to perform with high degree of accuracy.
- Strong analytical skills to review documents and reach sound decisions
- Proven oral and written communication skill set.
• Ability to:
◦ Meet multiple performance targets at or above benchmark levels; including, but not limited to: accuracy, call quality, timeliness, and productivity. ◦ Work harmoniously with peers within a small team environment to accomplish both personal and team performance goals. ◦ Work with customers in a professional and empathic manner ◦ Work overtime, as needed, to meet daily deadlines ◦ Work simultaneously with multiple computer systems ◦ Compute moderately difficult mathematical calculations
· Available for 8 hour shift between 8am to 8pm working hours; Work from home
EEO/Minorities/Females/Vets/Disabilities
Please be aware that EXL requires all employees to be vaccinated for COVID-19. This position will require the successful candidate to obtain and show proof of a vaccination. EXL is an equal opportunity employer, and will provide reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.
Please also note that the data shared through the job application will be stored and processed by EXL in accordance with the EXL Privacy Policy.
"Base Salary Range Disclaimer: The base salary range represents the low and high end of the EXL base salary range for this position. Actual salaries will vary depending on factors including but not limited to: location and experience. The base salary range listed is just one component of EXL's total compensation package for employees. Other rewards include bonuses and/or commission, as well as a Paid Time Off policy, and many region specific benefits
Originally posted on Himalayas