TL-Encounters

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.
  
  

• 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.