Senior Associate - Claims Intake Specialist

About
Capgemini

With more than 180,000 people in over 40 countries,
Capgemini is a global leader in consulting, technology and outsourcing
services. The Group reported 2015 global revenues of EUR 11.9 billion. Together
with its clients, Capgemini creates and delivers business, technology and
digital solutions that fit their needs, enabling them to achieve innovation and
competitiveness. A deeply multicultural organization, Capgemini has developed
its own way of working, the Collaborative Business Experience™, and draws on
Rightshore®, its worldwide delivery model.

Learn more about us atwww.capgemini.com.

Rightshore® is a trademark belonging to Capgemini.

Capgemini is an Equal Opportunity Employer encouraging
diversity in the workplace. All qualified applicants will receive consideration
for employment without regard to race, national origin, gender
identity/expression, age, religion, disability, sexual orientation, genetics,
veteran status, marital status or any other characteristic protected by law.

This is a general description of the Duties,
Responsibilities and Qualifications required for this position. Physical,
mental, sensory or environmental demands may be referenced in an attempt to
communicate the manner in which this position traditionally is performed.
Whenever necessary to provide individuals with disabilities an equal employment
opportunity, Capgemini will consider reasonable accommodations that might
involve varying job requirements and/or changing the way this job is performed,
provided that such accommodations do not pose an undue hardship.

Click the following link for more information on your rights
as an Applicant:http://www.capgemini.com/resources/equal-employment-opportunity-is-the-law

Job Title: Claims Intake Specialist

Department: Customer Contact Center

Reports to: Supervisor

Location: Pensacola, FL

SUMMARY

This job provides customer service in a
LTC Insurance call center environment by primarily receiving and responding to
telephone inquiries from policyholders, beneficiaries, providers, agents, or
others for information concerning Long Term insurance policies by performing
handling inbound and outbound calls responsibilities include initiating a Long
Term Care claims as well as follow-up for claim completion including the
following duties. This job would also
require advance knowledge of all processes and would be consider the subject
matter expert within the department.

ESSENTIAL DUTIES AND RESPONSIBILITIES
include the following. Other duties may be assigned.

Responsible for initial interaction
with Insured/Provider/Family, etc. to gather information by following a script
with open ended and reflexive questioningResponsible for timely follow ups
involving outbound calls to claim intake contact person in order to complete
intake script if minimum necessary questions have not been answeredAbility to recognize a misdirected call
and the knowledge to know where to appropriately direct the caller so that
their inquiries can be best addressedProvides information and assistance to
providers, agents, policyholders, and others by responding to telephone
inquiries from the client, LTC Insurance
policy holders , and their representative regarding policyAccurately provide information
regarding various LTC insurance policy related questions (i.e., any change
required in policy with respect to address change, bank change, name change
etc.) by accessing and updating software system data within company response
standards.Provides service and follow-up on LTC
insurance questions by researching company records to obtain information
requested by customerAbility to successfully handle all
level of calls including Admin, Claim, and Specialty callsMaintains working knowledge base of all
company products and services.Complying with company regulations
regarding HIPAA, confidentiality, and private health information.Providing written and oral
communication to policyholders and their representatives regarding a LTC
insurance policy that is in questionInitiate and complete Call Tracks,
Intake Scripts, checklists, and supportive clerical responsibilities as
necessary for completing LTC claims callAbility and Flexibility to work various
shifts as required.Ability to speak with Empathy and
Concern to PolicyholdersProvide training to news and existing
CCC Representatives on specific job tasks procedures and SOP’s , including
specific client company guidelinesCommunicate with CCC Supervisors,
Leads, Managers, and/or Director of Business operations of any “red flags”
regarding workload, training deficiencies or tools needed for job performance.Provide input and data as required to
support SLA requirementsHandles escalated complaints in a
timely mannerProvides feedback to Manager regarding
service failures or client concernsFamiliar with Medical Terminology
definitions and coding

SUPERVISORY RESPONSIBILITIES

This job has no supervisory
responsibilities.

QUALIFICATIONS

To perform this job successfully, an
individual must be able to perform each essential duty satisfactorily. The
requirements listed below are representative of the knowledge, skill, and/or
ability required. Reasonable accommodations may be made to enable individuals
with disabilities to perform the essential functions.

EDUCATION

High school diploma or general
education degree (GED); and six months related experience and/or training; or
equivalent combination of education and experience.

LANGUAGE SKILLS

Ability to read and comprehend simple
instructions, short correspondence, and memos.
Ability to write simple correspondence.
Ability to effectively present information in one-on-one and small group
situations to customers, clients, and other employees of the organization.

COMPETENCIES

Customer Service, excellent
communication skills, Integrity/Honesty, Oral Communication, Motivation,
Organizational/Planning/Organizing,

MATHEMATICAL SKILLS

Ability to add, subtract, multiply, and
divide in all units of measure, using whole numbers, common fractions, and
decimals.

TYPING

Typing speed of 45 WPM with a 90%
accuracy rate.

REASONING ABILITY

Ability to apply common sense
understanding to carry out detailed but uninvolved written or oral
instructions. Ability to deal with
problems involving a few concrete variables in standardized situations.

CERTIFICATES, LICENSES, REGISTRATIONS

Proficiency in computer applications
(including Word, Excel and Outlook) is required

AHIP and/or LOMA certifications
desired.

PHYSICAL DEMANDS

The physical demands described here are
representative of those that must be met by an employee to successfully perform
the essential functions of this job. Reasonable accommodations may be made to
enable individuals with disabilities to perform the essential functions.

While performing the duties of this
job, the employee is regularly required to sit and talk or hear. The employee is occasionally required to
stand and walk. Specific vision
abilities required by this job include close vision.

WORK ENVIRONMENT

The work environment characteristics
described here are representative of those an employee encounters while
performing the essential functions of this job. Reasonable accommodations may
be made to enable individuals with disabilities to perform the essential
functions.

The noise level in the work environment
is usually moderate.

PHYSICAL DEMANDS

The physical demands described here are
representative of those that must be met by an employee to successfully perform
the essential functions of this job. Reasonable accommodations may be made to
enable individuals with disabilities to perform the essential functions.