Subject Matter Expert SME - Insurance
Subject Matter Expert SME - Insurance
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
As a SME you will be the designated technical expert for a team of 2023 consultants who will carry out below tasks (but are not limited to):
- Patient Care: Coordinating case from multiple providers and helping injured patients who may not be able to manage their care on their own
- Manage administrative responsibilities: Helping patients with tasks like scheduling diagnostics (care coordinator activities)
- Diagnostics Voice & Back office and work includes reviewing prescription orders request for authorization from providers and prescreening of patients that will undergo diagnostics exam. The role requires strong clinical knowledge attention to detail and effective communication skills to collaborate with various stakeholders.
KEY RESPONSIBILITIES OF THE SME
- Empower the Work: Create facilitate Huddle Sessions to equip staff with fundamental skills and knowledge.
- Conduct BQM / Remedial training for the folks in nesting. Also conduct floor interventions for BQ teams.
- Strengthen relationships: Establish and maintain communication with clients and/or team members; understand needs resolve issues and meet expectations
- Take the lead: Delivering new hire training for the business ensure to give a good learning experience for the new hires ensuring to equip new hires with relevant skill set to meet the production goals from the first month post nesting Should partner with quality and training manager to identify skill and knowledge gap that leads to an instable performance trend Work with the training manager to prepare training content to run a BQ intervention for the business and Work with the training manager in catering the learning via the update management process and new launches.
- Support the team with complex queries and fill out accurate reports.
- Support the team manager and ensure the team delivers against key service levels metrics but also creates value for the clients by impacting business outcomes
- Handle phone calls and transactions for the program.
- Supervise and coach learners in nesting & BQM type environments;
- Coach and give feedback to trainees to help them fulfill performance metrics.
Qualifications :
MINIMUM QUALIFICATIONS:
- Minimum 24 months of healthcare/workers comp experience managing customerfacing accounts preferably managing processes such as intake scheduling credentialing medical bill reviews.
- Excellent Data Mining skills
- PHRN License
- Ability to think outside of traditional role to evaluate business implications
- Ability to interpret data identify trends and make suggestions for improvements
- Strong verbal and written communication skills; be able to communicate in a clear constructive and professional manner
- Demonstrated leadership skills; be able to take the lead in making improvements and resolving issues
- Blended operations which involve backoffice work making outbound and receiving inbound calls
- Working hours 80 of the team work 8am EST to midnight x 5 days a week. 20 team working in Philippines day hours (No calling)
- Willing to work from office
Additional Information :
All your information will be kept confidential according to EEO guidelines.
Remote Work :
No
Employment Type :
Fulltime
Employment Type
Full-time
