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.
Job title:
Job Description:
Education: Any Graduate
Experience: 3+ years experience in Claims Adjudication/Processing, Provider Enrollment / Provider Inquiry / PDM / Credentialing including 12 months in a supervisor capacity. Healthcare Industry Preferred
Roles & Responsibilities:
Provide day-to-day leadership, coaching and development support to direct reports (Sr. Process Consultants).
Review operating statistics regularly to ensure Client and Organization goals are being met in areas of service quality and timeliness. Typical areas of focus include: quality monitoring scores/daily work assignments, customer satisfaction, account notations, call handle times(If the process has voice requirement), abandon rates and service levels/ line adherence.
Identify areas of process improvement and work effectively within the organization to implement resolutions on a timely basis. Areas for improvement should be targeted at increasing client satisfaction and/or company profitability.
Oversee necessary enhancements to client programs or servicing therein. This may include areas such as staffing, training, attendance and quality.
Responsible for process quality for all work performed by the team.
Participate in client visits and roundtables to provide inputs on program performance or new programs being offered.
Coordinate with Manager Operations to balance needs of individual teams with needs of the entire organization.
Provide growth development opportunities.
Promote teamwork and cooperative effort.
Help train and provide guidance to Sr. Process Consultant, other Supervisors and Sr. Supervisors within the organization.
Maintain a clean, safe, unobstructed work area and practice good safety habits.
Provide internal and external customers with the highest quality service.
Familiarize with HIPAA regulations
Mandatory Skills:
Exceptional interpersonal, customer service, problem-solving, verbal and written communication, and conflict resolution skills.
Proficiency with the necessary technology, including computers, software applications, phone systems, etc.
Ability to understand basic data and take appropriate action.
Ability to drive individual and teams efficiency and productivity through effective and efficient metric management.
Ability to coach, train, and motivate employees and evaluate their performance.
Ability to strategically lead and develop team towards improved performance.
Ability to delegate and manage work loads and projects across functions within the organization.
• Ability to successfully drive continuous improvement efforts by leading various work streams related to call center metrics and monitoring tools.
Ability to problem solve, handle conflict, anticipate issues/concerns, troubleshoot problems, and proactively institute creative solutions.
Advanced customer focus and customer service skills
Preferred Skills:
Basic financial analysis (cost-effectiveness, cost-benefit etc.)
Location:
Skills Required
- Any graduate degree
- 3+ years of experience in claims adjudication or processing, provider enrollment, provider inquiry, PDM, or credentialing
- At least 12 months of experience in a supervisory capacity
- Healthcare industry experience
- Exceptional interpersonal, customer service, problem-solving, verbal and written communication, and conflict resolution skills
- Proficiency with computers, software applications, phone systems, and other necessary technology
- Ability to understand basic data and take appropriate action
- Ability to manage metrics and improve individual and team efficiency and productivity
- Ability to coach, train, motivate, and evaluate employees
- Ability to strategically lead and develop teams toward improved performance
- Ability to delegate and manage workloads and cross-functional projects
- Ability to lead continuous improvement efforts related to call center metrics and monitoring tools
- Ability to troubleshoot problems, handle conflict, anticipate issues, and implement solutions
- Advanced customer focus and customer service skills
- Basic financial analysis, including cost-effectiveness and cost-benefit analysis
- Familiarity with HIPAA regulations
What We Do
Sagility is a technology-led healthcare operations and business process optimization partner serving payers and providers. It combines healthcare expertise with artificial intelligence, intelligent automation, analytics, cloud platforms, consulting, and BPaaS to streamline claims, membership, clinical, payment-integrity, provider-network, and revenue-cycle workflows across the healthcare ecosystem. Its goal is to reduce administrative costs, improve member and provider experiences, and support better clinical and financial outcomes.
