SeniorExecutive

Reposted 2 Months Ago
Be an Early Applicant
Pasay, Southern Manila District, National Capital Region, PHL
Hybrid
Senior level
Information Technology • Database • Consulting
The Role
Lead quality assurance for client clinical claims review: track transactions, implement sampling, audit per guidelines, provide feedback, support training needs, manage rebuttal calls, run inter-rater reliability tests, report quality trends, onboard new agents, and prepare periodic quality reports.
Summary Generated by Built In

Track process transactions and implement sampling methodology

Audit client clinical claims review functions per process guidelines

Providing event-based and frequency-based feedback to stakeholders

Communicate case consults to Quality Management team both internally and client level 

Assisting operations in identifying training needs and process level issues that can help improve performance 

Ensure that rebuttal process is followed. This includes calls with client supervisors and managers both on quality and operations side

Participate in monthly inter-rater reliability tests to ensure process calibration 

Attend team meetings both internal and client level. This includes reporting quality trends and other client requested data, discussion of workflow, policies, procedures and initiatives

Brief new agents joining the process and explain how the quality function operates in the process

Assist with preparation of quarterly/monthly/annual quality reports

Establish effective rapport with clients and stakeholders
 

Responsibilities

Track process transactions and implement sampling methodology

Audit client clinical claims review functions per process guidelines

Providing event-based and frequency-based feedback to stakeholders

Communicate case consults to Quality Management team both internally and client level 

Assisting operations in identifying training needs and process level issues that can help improve performance 

Ensure that rebuttal process is followed. This includes calls with client supervisors and managers both on quality and operations side

Participate in monthly inter-rater reliability tests to ensure process calibration 

Attend team meetings both internal and client level. This includes reporting quality trends and other client requested data, discussion of workflow, policies, procedures and initiatives

Brief new agents joining the process and explain how the quality function operates in the process

Assist with preparation of quarterly/monthly/annual quality reports

Establish effective rapport with clients and stakeholders

Qualifications

Eligibility

  • No Attendance issues for 6 months (97% Reliability and QA Score of 97% & above)
  • No Disciplinary Actions from the last 3 months
  • With minimum of <3 years of Quality Assurance experience
  • Must be willing to work from office 100%


Skillset

  • Must be proficient in English oral and written communications
  • Must have advance skills in reporting and story telling
  • Must have intermediate to advance knowledge on Microsoft Application
  • Must possess critical thinking and problem-solving skills

Must have extensive knowledge of the Life Insurance and Annuities industry/processes

About Us
EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 54,000 employees spanning six continents. For more information, visit www.exlservice.com.


EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL’s Human Resources team, as well as our hiring managers.

Skills Required

  • No Attendance issues for 6 months (97% Reliability and QA Score of 97% & above)
  • No Disciplinary Actions from the last 3 months
  • With minimum of <3 years of Quality Assurance experience
  • Must be willing to work from office 100%
  • Must be proficient in English oral and written communications
  • Must have advance skills in reporting and story telling
  • Must have intermediate to advance knowledge on Microsoft Application
  • Must possess critical thinking and problem-solving skills
  • Must have extensive knowledge of the Life Insurance and Annuities industry/processes
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The Company
HQ: New York, NY
30,246 Employees
Year Founded: 1999

What We Do

Choosing a digital partner is about more than capabilities — it’s about collaboration and character. Unrealistic overhauls and off-the-shelf products ignore what matters most — your unique needs, culture, goals, and your legacy data and technology environments. At EXL, our collaboration is built on ongoing listening and learning to adapt our methodologies. We’re your business evolution partner—tailoring solutions that make the most of data to make better business decisions and drive more intelligence into your increasingly digital operations. Whether your goals are scaling the use of AI and digital, redesign operating models, or driving better and faster decisions, we’re here to partner with you to help you gain—and maintain—competitive advantage with efficient, sustainable models at scale. Our expertise in transformation, data science, and change management helps make your business more efficient and effective, improve customer relationships and enhance revenue growth. Instead of focusing on multi-year, resource- and time-intensive platform designs or migrations, we look deeper at your entire value chain to integrate strategies with impact. We use our specialization in analytics, digital interventions, and operations management—alongside deep industry expertise — to deliver solutions that help you outperform the competition. At EXL, it’s all about outcomes—your outcomes—and delivering success on your terms. Share your goals with us and together, we’ll optimize how you leverage data to drive your business forward. For more information, visit www.exlservice.com.

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