Associate - Operations

6 months ago

Gurugram 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:
**Job Description**:
Review medical records and produce an accurate summary of the patient's medical history

Check and review all forms and documents regarding a case for errors, missing information, and readability; and request tracking information as needed

Detect, interpret and update information related to the treatment of the patient's case, allowing physical health information to be converted into Electronic Medical Records

Ensure the creation of accurate summaries supported by medical literature

Interaction with managers regarding problem solving and understanding of the process

Ensure accurate documentation of medical history, suspected medications, and affiliated medications

Evaluate reports of adverse events to determine severity, causality, and expectations based on appropriate labeling

Verify coherence between the source documents and the narrative summary

Graduate in medical sciences such as B.Pharma, Nursing, Physiotherapist, Biotechnology with solid knowledge of diagnosis, medication, treatments and labs

Industry related course work is recommended but not required.

Experienced from 1 to 4 years understanding and summarizing records in chronological order

Ability to provide root cause analysis

Knowledge of personal injury, medical malpractice cases

Ability to read patient records and decode

Knowledge of mass tort/ product liability cases

Good knowledge of client-specific process rules and regulatory requirements

Expertise in medical terminologies

Excellent command over verbal and written communication skills

Good analytical, comprehension and time-management skills

Ability to act strategically and make sound business decisions

Ability to work in a team and good interpersonal skills

Shift

Night. Open to overtime if required.

Travel

Minimal upon request

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

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