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: 0-1 Year
Roles & Responsibilities:
Possess basic knowledge of Claims Administration (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.
Mandatory Skills:
Exceptional customer/ client interaction skills,
Ability to manage client escalations,
Experienced in managing client advocacy,
Excellent in usage of MS Excel to compile, collate and summarize
Preferred Skills:
MS office
Typing skills & computer skills
Effective communication in English
Good analytical skills
Comprehending ability
Location:
Skills Required
- Basic knowledge of Claims Administration (voice)
- Good reasoning and analytical skills
- Ability to communicate fluently in the required language
- Active listening skills
- Ability to process claims, handle incoming and outgoing calls per process guidelines
- Ability to comprehend process requirements and established procedures/policies before acting
- Maintain customer satisfaction via TAT and quality standards per client SLAs
- Use company policies to determine resolution or escalate to management
- Input and maintain customer records in company platform
- Manage client escalations and client advocacy
- Exceptional customer/client interaction skills
- Excellent usage of MS Excel to compile, collate and summarize
- MS Office proficiency
- Typing and general computer skills
- Effective communication in English
- Passion to learn
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.
