Associate-Back Office-Customer Service

1 day ago


Cochin, Kerala, India EXL Full time
Description
  • Handle complex healthcare cases such as claims rework, provider appeals, and documentation analysis with minimal supervision.
  • Retrieve supporting documents from various systems, create appropriate case files, and ensure accurate attachment and classification.
  • Analyze each case to determine resolution or escalation to Subject Matter Experts (SMEs).
  • Implement SME guidance to complete case processing effectively and accurately.
  • Generate customer communication letters and ensure timely dispatch as per process requirements.
  • Conduct root cause analysis for rework and escalations; recommend corrective and preventive actions.
Responsibilities
  • Handle complex healthcare cases such as claims rework, provider appeals, and documentation analysis with minimal supervision.
  • Retrieve supporting documents from various systems, create appropriate case files, and ensure accurate attachment and classification.
  • Analyze each case to determine resolution or escalation to Subject Matter Experts (SMEs).
  • Implement SME guidance to complete case processing effectively and accurately.
  • Generate customer communication letters and ensure timely dispatch as per process requirements.
  • Conduct root cause analysis for rework and escalations; recommend corrective and preventive actions.
Qualifications

Graduation with good in communication


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