天津招聘

Main duties/Responsibilities (list no more thanten items) 
? Respond accurately within the time commitmentgiven to enquiries regarding plan design, eligibility, claims status andperform necessary action as required, with first call resolution wherepossible. 
? Adjudicate claims in accordance with policyterms and conditions to meet personal and team productivity and quality goals. 
? Monitor turn around times to ensure claims aresettled within required time scales, highlighting when this is not achievable. 
? Monitor and highlight high cost claims andensure relevant parties are aware. 
? Provide payment guarantees as required toclients and providers. 
? Interface effectively with internal andexternal customers to resolve customer issues. 
? Work closely with Sales and Account Managementteam to provide and develop service for clients. 
? Identify potential process improvements andmake recommendations to appropriate management staff. 
? Actively support all team members and provideresource to enable all operational goals to be achieved 
? Performance metrics will increase over timewith proficiency and complexity of work. Initial productivity will requireaccurate response or completion of 15-20 items per hour, to include a mix ofcalls/ claims / faxes / emails) 
? Meet or exceed Service level agreementrequirements. Minimally set at a 10 day turnaround for claims or in accordancewith client specific requirements. This number will be reviewed periodicallyand can be increased or decreased based on business need.

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