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Associate - Operations

3 months ago

Gurgaon, Haryana, India Guardian Life Insurance Company Full time

Job Description:


The Team Member (TM) is the associate responsible to ensure we are delivering timely and accurate information to each and every participant.

The TM works with the Delivery Manager (DM) to identify process improvements by identifying issues, process delays, and quality problems and recommends solutions.

The TM works with the OM and others to resolve participant issues. The TM is responsible for workflow management and for resolving participant issuesThe main duties and responsibilities of Junior / Senior Executive

Executes Issue/Query Resolution

Ensuring proper documentation and follow-ups

Telephone and written queries resolution as per the standard procedures

Ongoing delivery of quality service

Ensure service accuracy through compliance (TAT)

Maintain documentation of SOP's/Operating Instructions

Identify, share, and implement process Improvements

Compliance to TRBS & MIS

Processes are thoroughly executed

All Service Level Agreements (SLA) are met (workflow closeout, etc.)

Ensure information is processed in an accurate and timely manner in order to achieve agreed

Qualifications:

Position Objective:

The Group Medical UW is responsible for screening and summarize case/ documents in accordance with established company guidelines and procedures.

The main objective is to obtain & analyze requirements that are needed to underwrite applicants.

Job Profile:

Major Opportunities and Decisions:

  • Evaluate medical, financial, and nonmedical information to determine the risk classification according to company guidelines
  • Reviews Evidence of Insurability (EOI) forms, medical records, coordinates completion of medical testing and history to appropriately review requests; recommend decisions on issuance or declination
  • Consult with Medical Director and Senior MUW staff for resolving complex medical/claims histories
  • Communicate with Medical vendors to ensure the timely completion of medical testing and gathering of medical histories.
  • Applies knowledge of Federal and State legislation related to Group Insurance Products.
Functional Skills

  • Work experience involving assumption of insurance risk is a plus.
  • Experience involving comprehension of medical diagnoses is a plus
  • Knowledge of Group Insurance products and / or processes is a plus
  • Examining insurance proposals
  • Demonstrated ability to work in a highvolume setting to accurately and quickly process assigned work
  • Focus on quality, accuracy and productivity

Competencies/Skills:

  • Ensure high level of customer service for internal or external customers
  • Be multiskilled to manage all kinds of queries as per the company guidelines
  • Expresses oneself in an open and honest manner
  • Demonstrates selfawareness and embraces feedback
  • Attention to detail
  • Good written and oral communication skills
  • Excellent organizational and time management skills

Knowledge:

  • Education and Experience: Medical/Life Science graduation preferred, additional education in Medical terminology, anatomy and physiology strongly preferred
  • 35 years of Group or Medical Underwriting experience
  • US Federal Laws, APS, testing and Summarization experience preferred.
  • Industry related course work is recommended but not required
Shift

  • Rotational. Ability to work evening / night shift as per business requirement.
  • Open to overtime if required.
Travel

  • Minimal upon request

Location:

This position can be based in any of the following locations:
Gurgaon