Job Description:Job DescriptionJob title Asst Unit ManagerReports to Operations Manager / Sr. Manager OperationsManage Delivery of services for Third party administrators, Health Maintenance organizations, preferred provider organizations, managed care organizations and many more in US healthcare insurance market. The ultimate motive is to ensure commendable service standards and maintain very high customer satisfaction.Duties and ResponsibilitiesListed below are the primary job duties and responsibilities that are required: Applying Healthcare domain knowledge, theoretical concepts etc. to undertake problem solving Deliver assigned tasks within agreed SLA Ensuring accurate and timely completion of transactions to meet or exceed client SLA's (Service Level Agreements) Staying current with knowledge of products/ processes & services offered by the client Ensure 100% adherence to schedule. Meeting and improving all defined targets like AHT, quality, schedule adherence, maintenance of reports etc.. Conduct regular One-on-One with the Team Preparation and submission of periodic reports to client. Ensuring complete satisfaction of the customers / clients. Handle escalations. Assist the Operations Manager in roistering. Motivating each Team Member, guiding, monitoring their performance and implementing corrective actions as required. Identifying the training requirements of each Team Member and providing for the same in the appraisal sheets. To ensure that he conducts a daily team briefing/debriefing before and after the shifts respectively. To ensure that at no point in time the floor lacks supervision Understanding of company policies and procedures and effectively applying the same Absenteeism and attrition Management ComplianceExperiency and Skills requirements for this role: Minimum four (3 years) years’ experience in Claims Adjudication. Medical claims processing experience is a must. Knowledge in Plan Building will be an added advantage. Familiarity of Healthcare laws and legislative including the HIPAA (Health Insurance Portability and Accountability Act) Should be good with MS Office and training reporting. Candidate with additional experience in auditing claims will be preferred. Advance knowledge of ICD 9 – 10 and CPT coding and general practice of claims processing. Professional demeanor and commitment to team culture. Good Presentation skills Proficiency in MS Office People Management Coaching SkillsBehavioral Skills: Look up for relevant information and update (type into) the client systems as per set procedures and policies. Attention to detail while accomplishing tasks, meeting Weekly / Daily targets with required quality in the given timelines. Review data for deficiencies or errors, correct any incompatibilities if possible. Adhere to the team norms for making the overall team a cohesive one. Ability to prioritize and manage workload. Must be ready to work in night shifts.Qualification: Bachelor’s degree Operational experience of at least 4- 6 years Healthcare experience: 3-4 years Should have handled a team for 6 to 12 months Good communication skill and ability to work well with people is essential. Proficiency with computers is a must Should possess basic analytical reasoning skillsSkills:PRIMARY COMPETENCY : Healthcare PRIMARY SKILL : Healthcare-Claims Adjudication PRIMARY SKILL PERCENTAGE : 100About Company:Mphasis is a leading IT solutions provider, offering Applications, Business Process Outsourcing (BPO) and Infrastructure services globally through a combination of technology knowhow, domain and process expertise. The accolades we have been garnering can be attributed to our undeterred focus in delivering quality solutions across verticals that meet the challenging requirements of our esteemed customers. We have been recently felicitated by the economic times as the most distinguished digital company 2015. We have also been ranked 29 of 100 largest financial technology vendors by American Banker and BAI in the FinTech Forward Top 100 rankings.
