Case Analyst

2 days ago

vadodara, India Asian Hires Full time

POSITION SUMMARY

Case Analyst in Lien Operation assumes a pivotal role, working closely with the US team lead for selected lien type to

perform negotiation, arbitration, and settlement of lien amount with external entities. Daily activities will include

reviewing aging liens and performing tasks like raising compromise request, performing audit review without protocol

or code set, disputes review, sending final demand, 3rd level CPL audit etc. Other responsibilities may include but not

limited to updating Management Information Systems (MIS), providing oversight on quality feedback, communicating

essential updates within the team, and conducting training sessions for team members.


JOB RESPONSIBILITIES

• Perform medical lien review to ensure smoother transition of liens across the stages and to perform lien

negotiation if required.

• Drafting outbound correspondence and timely uploading outbound and inbound documents to our proprietary

database.

• Auditing medical claims itemizations and investigating discrepancies. This includes audit without protocols

and 2nd level or higher-level audit checks.

• Developing relationships with lien agencies by communicating professionally and effectively among multiple

modes, including phone calls and email.

• Timely following up on assigned files and exercising judgment regarding escalating problematic files to a

senior case analyst or management.

• Develop and uphold Standard Operating Procedures (SOPs) and comprehensive training documents.

• Manage process transitions and conduct training sessions for both On-Job Training (OJT) and Business as

Usual (BAU).

• Deliver training to both existing and new associates, ensuring alignment with performance standards.


KNOWLEDGE AND SKILLS

• Bachelor’s degree in any stream (preferably- commerce background).

• Proven 3- 5 years of experience in US-based MNC.

Technical Skills:

• Data entry skills: A typing speed of at least 60 WPM with above average spelling, grammar, and diction skills.

• Advance MS office skills including MS Excel (Pivot Tables, VLOOKUP, conditional formula, Tables,

Formatting, Creating Dashboard, etc) and Proficiency in Outlook (Create Rules, Manage Different Mailbox,

Manager Calendar, etc.). Basic knowledge of SQL query will be appreciated.

• Exhibit proficiency in both written and verbal communication, showcasing the ability to comprehend provided

information and draw appropriate conclusions.

• Adept at seamlessly transitioning new processes and establishing comprehensive Standard Operating

Procedures (SOPs) and documentation. Demonstrates the ability to effectively disseminate knowledge to team

members for enhanced operational understanding.

• Possesses robust analytical capabilities, enabling the identification and resolution of complex issues.

• Actively seeks opportunities to refine existing workflows, contributing to overall operational excellence.

Behavioral Skills:

• Demonstrates strong problem-solving abilities, analyzing alternatives and implementing effective solutions to

address work-related challenges.

• Ability to be discrete and maintain high levels of confidentiality.

• Have excellent customer service, interpersonal, listening, and problem-solving skills.

• Are professional and strong with both oral and written communication.

• Displays agility, capable of functioning both as a sole contributor and a collaborative team player as needed.

• Possesses a keen eye for details and subtle shifts, proactively identifying potential problems and devising

solutions before they escalate.

• Exhibits flexibility and adaptability, responding swiftly in fast-paced workplaces to meet shifting demands.

Open-minded and flexible in various scenarios.


ADDITIONAL NOTES

• Knowledge of US Insurance/liens will be an added advantage.

• Previous experience in operations and business analysis is preferable.


CAREER PROGRESSION

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