Team Lead - Claims Examiner
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 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
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 Location: Horsham Township,
Reports To: Manager
This job is responsible for providing quality and efficient
customer service in an office environment.
Additional responsibilities include assisting manager with development,
analysis and implementation of staffing training.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.
Ensure claims are
adujicated as per the guidelines of the company. Provide continual evaluation
of processes and procedures. Responsible
for suggesting methods to improve area operations, efficiency and service to
both internal and external customers.Provide statistical and performance feedback and coaching on a
regular basis to each team member. Write
and administer performance reviews for skill improvement.Provide support for fellow team members by providing appropriate
coaching, counseling, direction and resolution.Ensure fellow employees have appropriate training and other
resources to perform their job. Respond to and resolve customer issues. Assist manager with daily operation of claims processing to
include development, analysis and
implementation of staffing and training.Work as a member/leader of special or on-going projects that are
important to area/process improvement.Share continual responsibility and ensuring calls are handled
efficiently and effectively.Establish work procedures and processes that support company and
departmental standards, procedures and strategic directives.Communicate with upper management regarding department or employee
concerns.Complying with company regulations regarding HIPAA,
confidentiality, and private health information.
To perform these jobs 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.
Excellent oral, written and interpersonal communication skillsKnowledge of Microsoft Office applications and telephone protocolExceptional listening and analytical skillsStrong knowledge of customer care processes and techniquesDemonstrated ability to work well in a team environmentDedication to providing exceptional customer serviceProven leadership experienceAbility to develop and motivate a team.Ability to provide and support company goals.
EDUCATION and/or EXPERIENCE
One year certificate from college or technical school; or one year
to 18 months relatedexperience and/or training; or equivalent combination of education
and experience; BA preferredExcellent communication skills both verbal and written are
required.Working knowledge of Inspro, AS400, Capsil, and Cisco is
Ability to read, analyze, and interpret general business
periodicals, professional journals, technical procedures, or governmental
regulations. Ability to write reports, business correspondence, and procedure
manuals. Ability to effectively present
information and respond to questions from groups of managers, clients,
customers, and the general public.
Ability to calculate figures and amounts such as discounts,
interest, and percentages. Ability to
apply concepts of basic algebra.
Ability to define problems, collect data, establish facts, and
draw valid conclusions. Ability to interpret an extensive variety of technical
instructions in mathematical or diagram form and deal with several abstract and
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.
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.