Senior Process Consultant

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

The role of an associate is to contribute to the overall team performance and profitability by implementing action plans which in return will improve and maintain client satisfaction.

Job title: Senior Process Consultant

Education: Any Graduate

Experience: 2-3 Years RCM-AP/AR(Voice) Experience

Mandatory Skills:

• Strong understanding of medical terminology and coding.
• Proficient in Microsoft Office Suite (Word, Excel, PowerPoint).
• Excellent attention to detail and accuracy.
• Excellent written and verbal communication skills.
• Strong leadership and problem-solving skills.
• Ability to work independently and as part of a team.

Preferred Skills:

• US health care (ERISA/HIPAA/State Mandates)
• Process SLA
• Awareness of ISO, ISMS
• Telephone etiquettes
• MS office
• Typing skills & computer skills
• Effective communication in English

Roles & Responsibilities:

• Possess basic knowledge of RCM-AP/AR(Voice)
• Good reasoning and analytical skills
• Able to communicate fluently in the language required for the function/location
• Active listening skills
• Passion to learn
• Influencing skills
• Ability to comprehend the process requirement well
• Processing claims/handling incoming calls/making outgoing calls and take appropriate actions as per the process guidelines.
• Understand the basic professional standards and established procedures, policies before taking action and making decisions.
• Maintain customer satisfaction ratings through TAT and quality standard basis client SLA’s
• Use company policies to determine if there can be an immediate resolution to a customer issue or if that issue requires managerial input
• Input data into the company platform to keep each customer record updated
• Responsible for multiple administrative and customer service layers that includes solving customer issues through review, investigation, adjustment (if necessary), remittance or denial of the claim by utilizing company policies and directing queries to the managerial team when necessary.
• Individuals should have commitment to customer satisfaction and an ability to make quick and accurate decisions.
• Mentor & coach new members of the team based on requirement
• To act as a subject matter expert
• Ability to look for alternative solutions for problems identified; Takes decisions based on logical reasoning and relevant information
• Assumes responsibility for work activities and coordinating efforts

Location: HYD, Purva Summit - Devx 4th floorIndia