Essential Functions
• Analyze, validate and process transactions as per Desktop procedures (L3 & L4)
• Analyze and research all discrepancies.
• Research & investigate and resolve outstanding items
• Determine eligibility and applicable plan provisions while meeting timeliness goals
• Clear and accurate written and verbal communication (Scripted and Templatized) with employee,
employer & stateside resources by email
• Establish action plans for each file to bring claims to resolution
• Utilize internal and external specialty resources to maximize impact on each claim file
• Utilize Intellis and ACS (SIR) to update and maintain accurate data record
• Use PC programs to increase productivity and performance
• Ensure that the assigned targets are met in accordance with SLA and Internal standards
• Ensure that the quality of transaction is in compliance with predefined parameters as defined by Process
Excellence
• Work as a team member to meet office goals to obtain disability’s vision while demonstrating core values
and meeting key measures.
• Ensure adherence to established attendance schedules
• Sedentary work - involves sitting most of the time
• Close visual acuity - viewing a computer terminal and extensive reading
• Talking - expressing or exchanging ideas by means of the spoken word
• Capturing the medical, personal & employment details from Employee, Health Care Provider(via email - free flow communication)
Any other essential function that may occur from time to time as directed by the Supervisor.
Primary Internal Interactions
• AM for the purpose of reporting performance, escalation handling, clarifying concerns, and seeking
feedback and support.
• Manager for the purpose of settling issues left unresolved by the AM and monthly evaluation of
performance.
• Subject Matter Expert for the purpose of work thread related issues and escalated transactions.
• QCA for the purpose of feedback and audit.
• Trainers for the purpose of Pre-process and Process training.
اطلب مساعدة الخبراء لكتابة سيرة ذاتية مميزة.