Job Summary
The TL-Encounters role is pivotal in ensuring the seamless processing and adjudication of claims within our hybrid work model. With a focus on Facets and UiPath the candidate will leverage their expertise in Provider and Payer domains to optimize workflows and enhance operational efficiency. This night shift position requires a proactive approach to problem-solving and a commitment to delivering high-quality results.
Responsibilities
- Lead the team in the efficient processing of claims using Facets to ensure accuracy and compliance.
- Oversee the automation of routine tasks through UiPath to enhance productivity and reduce manual errors.
- Provide expert guidance on claims adjudication processes to ensure timely and accurate settlements.
- Collaborate with cross-functional teams to streamline workflows and improve overall service delivery.
- Analyze and resolve complex issues related to Provider and Payer domains to support business objectives.
- Develop and implement strategies to optimize claims processing and reduce turnaround times.
- Monitor system performance and identify opportunities for improvement to enhance operational efficiency.
- Ensure adherence to industry regulations and company policies in all claims processing activities.
- Facilitate training sessions to upskill team members on the latest tools and technologies.
- Conduct regular audits to maintain data integrity and compliance with established standards.
- Communicate effectively with stakeholders to provide updates on project progress and challenges.
- Drive continuous improvement initiatives to foster innovation and excellence within the team.
- Support the development of best practices and standard operating procedures to ensure consistency.
Qualifications
- Possess strong technical skills in Facets and UiPath essential for optimizing claims processing.
- Demonstrate expertise in claims adjudication crucial for accurate and timely settlements.
- Have in-depth knowledge of Provider and Payer domains vital for understanding industry dynamics.
- Exhibit excellent problem-solving abilities necessary for resolving complex issues.
- Show proficiency in automation tools important for enhancing operational efficiency.
- Display strong communication skills essential for effective stakeholder engagement.
- Maintain a proactive approach to learning and adapting to new technologies and methodologies.
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