CQM Process Coordinator
4 days ago
Job Overview
FATORAH Insurance Claims Settlement LLC is a leading provider of insurance claims settlement services. We are seeking a highly skilled CQM Coordinator to join our team.
Role Summary
The successful candidate will be responsible for coordinating the claims process, identifying network issues, and communicating with IT to resolve them. They will also meet regularly with team members to discuss challenges in the claims process and escalate IT on network issues.
Primary Responsibilities
- Claims Allocation: Allocate claims to team members, ensuring that claims are allocated fairly and efficiently.
- Issue Reporting: Report back to line managers/onsite managers on any issues that may affect the claims process.
- Team Meetings: Meet with team members regularly to discuss challenges in the claims process.
- IT Escalation: Escalate IT on network issues, track them, and keep a record of the issues in a shared folder.
- CQM Process Monitoring: Monitor the CQM process within given TAT with the provider as well as the end user.
- Issue Escalation: Gather relevant information to clearly describe and properly escalate issues to supervisors and managers.
- Customer Service: Ensure high-quality customer service and respect medical and work ethics at all times while conducting daily tasks.
- Documentation: Ensure that business decisions and processes are documented professionally and that communication requirements are adhered to in a timely and professional manner.
- Support: Provide all the needed support as advised by the supervisor based on the business need.
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