Claims Processor- Contract Onsite

Role Purpose

The purpose of the role is to provide effective technical support to the process and actively resolve client issues directly or through timely escalation to meet process SLAs.

Do

Support process by managing transactions as per required quality standardsFielding all incoming help requests from clients via telephone and/or emails in a courteous mannerDocument all pertinent end user identification information, including name, department, contact information and nature of problem or issueUpdate own availability in the RAVE system to ensure productivity of the processRecord, track, and document all queries received, problem- solving steps taken and total successful and unsuccessful resolutions Follow standard processes and procedures to resolve all client queriesResolve client queries as per the SLA’s defined in the contract Access and maintain internal knowledge bases, resources and frequently asked questions to aid in and provide effective problem resolution to clientsIdentify and learn appropriate product details to facilitate better client interaction and troubleshooting Document and analyze call logs to spot most occurring trends to prevent future problemsMaintain and update self-help documents for customers to speed up resolution timeIdentify red flags and escalate serious client issues to Team leader in cases of untimely resolutionEnsure all product information and disclosures are given to clients before and after the call/email requestsAvoids legal challenges by complying with service agreements

Deliver excellent customer service through effective diagnosis and troubleshooting of client queriesProvide product support and resolution to clients by performing a question diagnosis while guiding users through step-by-step solutions Assist clients with navigating around product menus and facilitate better understanding of product features Troubleshoot all client queries in a user-friendly, courteous and professional mannerMaintain logs and records of all customer queries as per the standard procedures and guidelinesAccurately process and record all incoming call and email using the designated tracking softwareOffer alternative solutions to clients (where appropriate) with the objective of retaining customers’ and clients’ business Organize ideas and effectively communicate oral messages appropriate to listeners and situationsFollow up and make scheduled call backs to customers to record feedback and ensure compliance to contract /SLAs

Build capability to ensure operational excellence and maintain superior customer service levels of the existing account/client Undertake product trainings to stay current with product features, changes and updatesEnroll in product specific and any other trainings per client requirements/recommendationsPartner with team leaders to brainstorm and identify training themes and learning issues to better serve the clientUpdate job knowledge by participating in self learning opportunities and maintaining personal networks

Stakeholder Interaction

Stakeholder Type

Stakeholder Identification

Purpose of Interaction

Internal

Team Leaders

Performance review

HR

Hiring and employee engagement and retention

Training Team

Capability development

Technical Lead

Training, issue escalation/ resolution

External

Client

Query Resolution

Display

Lists the competencies required to perform this role effectively:

Functional Competencies/ SkillProcess Knowledge - Knowledge of assigned process, tools and systems - Foundation to Competent

Competency Levels

Foundation

Knowledgeable about the competency requirements. Demonstrates (in parts) frequently with minimal support and guidance.

Competent

Consistently demonstrates the full range of the competency without guidance. Extends the competency to difficult and unknown situations as well.

Expert

Applies the competency in all situations and is serves as a guide to others as well.

Master

Coaches others and builds organizational capability in the competency area. Serves as a key resource for that competency and is recognized within the entire organization.

Behavioral Competencies Collaborative workingProblem solving and decision makingAttention to DetailExecution ExcellenceClient (Internal) CentricityEffective Communication

Deliver

No.

Performance Parameter

Measure

Process

No. of cases resolved per day, compliance to process and quality standards, meeting process level SLAs, Pulse score, Customer feedback

Self- Management

Productivity, efficiency, absenteeism, Training Hours, No of technical training completed