Jobs at EXL South Africa

Job Description

• Support with Member queries for Healthcare Client

Responsibilities

• Support with Member queries for Healthcare Client

Qualifications

• 6 month Call Centre and Grade 12 Pass

go to method of application »

Job Description

• Answers questions to providers related to Benefit Plans, Claims and related topics
• To communicate effectively for additional information as needed by providers
• Perform accurate data entry
• Perform eligibility and benefit verification
• Create effective, grammatically correct and compliant written communications and demonstrate effective listening and soft skills, engaging in effective dialogue through proper, clear, and effective verbal communication

Responsibilities

• Answers questions to providers related to Benefit Plans, Claims and related topics
• To communicate effectively for additional information as needed by providers
• Perform accurate data entry
• Perform eligibility and benefit verification
• Create effective, grammatically correct and compliant written communications and demonstrate effective listening and soft skills, engaging in effective dialogue through proper, clear, and effective verbal communication

Qualifications

• Good computer navigation skills
• Typing speed of 30 Words per Minute with 95% Accuracy 
• Well versed with basic functions of Microsoft Office (Word, Excel, PowerPoint, Outlook)
• Ability to work and collaborate effectively with internal customer
• Preferred knowledge of medical terminology
• Preferred ability to make sound decisions under the direction of Supervisor
• Preferred ability to analyze and resolve problems with minimal supervision
• Ability to navigate multiple systems and applications 
• Ability to produce high quality outcomes in a highly productive environment.
• Ability to make sound judgments based on available information.
• Excellent written and oral communication skills 
• Strong critical thinking skills and attention to detail
• Experience in using email and Web-enabled applications

go to method of application »

Job Description

Essential Functions

• Responsible for designing new processes for QC functioning to meet client specific requirements; facilitate migrations to seamlessly set up quality compliance.
• Leads significant process improvement projects.
• Train / mentor personnel from other functions on quality tools and concepts and mentor AMs / GBs
• Responsible for ensuring ongoing compliance to quality standards based on internal as well as client requirements.
• Responsible for working closely with clients and operations team to carry out process improvement activities and facilitate best practice sharing and driving standardization.
• Perform ongoing reviews to ensure compliance to QSD to all certification and internal / client requirements.

Skills

Technical Skills

• Trained / Certified Lean Six Sigma Green Belt from a reputed organization with 7-9 years of experience
• Excellent working knowledge of MS Office, MS Excel, Power Point, Word Doc, Outlook
• Process Mapping/Value Stream Mapping
• Knowledge of calls recording system and its usage (NICE, Witness, etc) preferred

Process Specific Skills

• Knowledge of industry domain being aligned to healthcare
• Knowledge of quality systems (ISO, COPC) preferable

Soft skills (Desired)

• Project management skills to drive improvement projects / initiatives
• Analytical skills

Soft Skills (Minimum)

Functional

• Leads engagements at vertical / program / client level
• Understands business requirements and provides appropriate solutions to benefit the business
• Has the ability to identify superior improvement opportunities
• Knowledge of quality assurance, process improvements, domain, etc
• Monitoring and Reviewing

Leadership

• Fosters a spirit of collaboration and team work
• Ability to relentlessly pursuing excellence

General

• Conformance to policies / compliances with auditing skills and eye for details
• Ability to coach and give feedback on an ongoing basis.
• Interviewing skills
• Strong written and verbal communication Skills.
• Problem solving skills
• Ability to resolve conflicts constructively and lead in a continually challenging environment

Education Requirements

• Graduate in any stream
• Exposure to quality systems (ISO, COPC, etc) preferred

Work Experience Requirements

• Minimum 8 years of total work experience with at least 2 years of relevant in BPO / ITES industry
• Minimum 5 year in the current role/assignment

go to method of application »

Job Description

• In this role, you'll be tasked with ensuring the achievement of assigned targets in alignment with Service Level Agreements (SLAs). Your responsibilities include upholding transaction quality within predefined parameters and controlling claim costs to minimize leakage. Maintaining accuracy in reserves and payments while managing the lifecycle of claims is crucial.
• Adherence to company policies and procedures is paramount to ensure operational efficiency. You'll be responsible for managing both inbound and outbound calls, as well as other correspondence related to claims.
• Emphasizing customer satisfaction, building rapport, and facilitating effective communication are key aspects of this position, aiming for timely resolution of customer concerns.
• Additionally, you'll be expected to fulfill any other essential functions as directed by the supervisor. Join us in delivering excellence and maintaining high standards in claims management.

Responsibilities

• Ensure that the assigned targets in accordance with SLA are met  
• Ensure that the quality of the transactions is in compliance with predefined parameters  
• Ensure claim costs is controlled and leakage kept at a minimum
• Ensure accuracy of reserves and payments and manage lifecycle of claims
• Ensure adherence to Company Policies and Procedures
• Managing calls – both inbound and outbound as well as all other correspondence on claims
• Focus on Customer Satisfaction, rapport building, effective communication and timely resolution of Customer concerns 
• Any other essential function that may occur from time to time as directed by the Supervisor

Qualifications

• English language proficiency
• Previous international Voice experience
• Good Computer navigation skills
• Should be familiar with MS Office 
• Possesses necessary knowledge of business concepts to effectively perform the job
• Makes decisions in a timely manner; shows good judgment about when to make decisions independently and when to collect more information or involve others. 
• Commits to achieving specific objectives and takes ownership for accomplishing them.
• Responsible for handling high volumes of transactions.
• Effectively balances quality, timeliness and productivity standards
• Self-discipline
• Result orientation 
• Adaptability 
• Listening and comprehension skills 
• Questioning and Reasoning Skills
• Customer Service focus and telephone etiquette
• Ability to multi task, prioritize and manage daily work activities