Claims Senior Representative
hace 2 días
Job Title: IOH Claims Senior Representative
Job Summary:
We are seeking a highly motivated and experienced Claims Senior Representative to join our team in Madrid. As a key member of our Operations Team, you will be responsible for delivering specific delegated Claims tasks assigned by a supervisor, examining and processing paper claims and/or electronic claims, and determining whether to return, pend, deny or pay claims within policies.
Main Responsibilities:
- Provide coaching and development for Claims team staff
- Review team performance and ensure coaching opportunities are identified
- Ownership of BPO team scorecards, updating performance and ensuring coaching opportunities are identified when required
- Quality Audit execution and reporting results, ensuring Quality Audit targets are achieved
- Engage staff to create a dynamic working environment at all levels, supporting the team and the processes towards continuous improvement while supporting the change journey
- Proactively optimize the unit's workflows to achieve set targets
- Managing the senior queues daily
- Monitoring and managing workflow to ensure TAT targets are achieved and inventory levels are managed
- Instrumental in the Claims Processes to ensure risks are highlighted
- 1st Point of contact for Escalations
- Mainframe and financial transactions
- Ad-hoc projects
- As required, processing or verifying
Requirements:
- 1 year experience in processing Provider claims
- Ability to complete tasks with little or no supervision
- Self-motivated with a proactive approach
- Exceptional attention to detail and accuracy
- Ability to take ownership
- Demonstrated Coaching/Development Experience
- Work well in a team environment
- Computer literacy (especially Excel)
- Ability to learn in a virtual environment
- Excellent problem-solving skills
- Confidentiality Management of Data
- Leadership Skills will be a plus
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