Customer Care Executive

Job Description:

The Trainee Process Consultant will support healthcare operations by handling voice-based claims administration and customer interactions. The role focuses on delivering accurate claim processing, excellent customer service, and adherence to quality and SLA standards to ensure high client and member satisfaction.

Key Responsibilities:

 Possess basic knowledge of Claims Administration (Voice)

 Good reasoning and analytical skills

 Able to communicate fluently in the language required for the function/location

 Active listening skills

 Passion to learn

 Influencing skills

 Ability to comprehend the process requirement well

 Processing claims/handling incoming calls/making outgoing calls and take appropriate actions as per the process guidelines.

 Understand the basic professional standards and established procedures, policies before taking action and making decisions.

 Maintain customer satisfaction ratings through TAT and quality standard basis client SLA’s

 Use company policies to determine if there can be an immediate resolution to a customer issue or if that issue requires managerial input

 Input data into the company platform to keep each customer record updated

 Responsible for multiple administrative and customer service layers that includes solving customer issues through review, investigation, adjustment (if necessary), remittance or denial of the claim by utilizing company policies and directing queries to the managerial team when necessary.