Works with Regional Medical Directors to make sound, evidence based clinical decisions regarding the requested cases (treatments and procedures) for IP/OP and performs retrospective clinical reviews utilizing criteria set forth by the client and Medicare (CMS-Centers
In this role, youll be tasked with ensuring the achievement of assigned targets in alignment with Service Level Agreements (SLAs). Your responsibilities include upholding transaction quality within predefined parameters and controlling claim costs to minimize leakage.
In this role, youll be tasked with ensuring the achievement of assigned targets in alignment with Service Level Agreements (SLAs). Your responsibilities include upholding transaction quality within predefined parameters and controlling claim costs to minimize leakage.
The Quality & Process Excellence function at EXL is to drive quality compliance for client business processes and creating value for clients through lean six sigma based process improvements. The team manages the entire QA management for
Accountabilities Ensure seamless transition and flawless service delivery Focus on transition with ‘Zero’ impact on service delivery Focus on efficiencies - leaner, greener and faster Focus on Process stabilization & sustained delivery
Answers questions to providers related to Benefit Plans, Claims and related topics To communicate effectively for additional information as needed by providers Perform accurate data entry Perform eligibility and benefit verification Create effective, grammatically correct and
Essential Functions: Meeting the SLA Targets Team management and Transaction/Call Monitoring Productivity Improvement and Employee engagement Client interaction, if required at supervisory level Ensure compliance with internal policies and procedures, external regulations and information security standards
HR Business Partners perform a specialized type of HR work focused on HR consulting to the business. This role focuses on partnering with business to shape the people infrastructure and culture needed to attract, engage, and
Essential Functions: Ensure that the process transactions are processed as per Desktop procedures Ensure that the assigned targets are met in accordance with SLA and Internal standards Ensure that the quality of transaction is in compliance
We are seeking an Information Security professional to join our team and lead initiatives across cyber risk management, security governance, and business continuity. The role will be responsible for strengthening security posture and resilience of critical
The Rewards & Benefits will lead the design, implementation, and management of all employee rewards programs, including compensation, benefits, and incentive plans. This role partners with Global Rewards and HR teams to ensure competitive, equitable, and
CCaaS Voice Manager – Responsible for managing and supporting cloud contact center and voice platforms, ensuring service availability, operational excellence, and successful delivery of telephony and dialer experience solutions. The role oversees CCaaS operations, voice infrastructure,
The Quality & Process Excellence function at EXL is to drive quality compliance for client business processes and creating value for clients through lean six sigma based process improvements. The team manages the entire QA management for
Basic Functions Generates month-wise, day-wise and interval-wise forecast incorporating historical trends and other factors such as special events, seasonality, chum or growth, weather etc. Runs short term forecast and re-forecast/adjust future volume projections as needed to
HR Business Partners perform a specialized type of HR work focused on HR consulting to the business. This role focuses on partnering with business to shape the people infrastructure and culture needed to attract, engage, and
Essential Functions Responsible for designing new processes for QC functioning to meet client specific requirements; facilitate migrations to seamlessly set up quality compliance. Leads significant process improvement projects. Train / mentor personnel from other functions on
We are seeking a dynamic Human Resources Business Partner (HRBP) to operate at both strategic and operational levels, delivering an exceptional employee and leadership experience. This role focuses on executing the people strategy and driving key
The Induction Administrator is a key operational role within the Talent Acquisition team, responsible for the seamless day-to-day administration of the new joiner induction programme from end to end. This position plays a vital supporting role
Duties & Responsibilities Responsible for Diagnostic to Solution Proposal creation for digital projects Identify game-changing capabilities by analyzing competitors and internal processes. Creative,consultative approach focused on future digital solutions for business challenges Foster relationships with key
Answers questions to providers related to Benefit Plans, Claims and related topics To communicate effectively for additional information as needed by providers Perform accurate data entry Perform eligibility and benefit verification Create effective, grammatically correct and