BPO Quality Analyst

NTT Data; Manila; On-site; PHP 500,000 - 800,000; Full time

Job summary

NTT Data is seeking a Transactional Quality Auditor to review claims transactions, analyze processes, and guide processors in making accurate decisions. You will map value streams, identify improvements, and help standardize procedures within the claims function.

With 3–5 years in quality auditing and knowledge of Life Insurance Claims, you will collaborate in an Agile environment, leverage Salesforce and mapping tools, and support ongoing training to ensure high standards of accuracy and

Qualifications

• Bachelor's degree required.
• 3–5 years of experience as a Transactional Quality Auditor/MIS specialist/Quality associate.
• Experience with Life Insurance Claims and Policy Administration.
• Strong communication skills (written and verbal) to clearly articulate business requirements to technical teams.
• Knowledge of process mapping tools such as MS Visio and Lucidchart.

Responsibilities

• Review claims transactions and provide feedback to claims processors to improve decisions.
• Develop and maintain knowledge of insurance products, services and processes.
• Perform functional analysis of current processes and identify improvements.
• Create process and value stream maps for current and new processes.
• Assist in establishing SOPs and knowledge transfer documentation.
• Collaborate with team members to meet customer goals.

Skills

Claims process redesign

Data analysis

Change management

Functional specifications

Agile

Stakeholder communication

Salesforce

Process mapping

Lean Six Sigma

Education

Bachelor's degree

Tools

MS Visio

Lucidchart

Excel

PowerPoint

Salesforce

Job description

Job Description

Review claims transactions and provide feedback to claims processors. Improve process efficiency & quality for existing and new processes through analysis and design of workflows and business processes.

Key Responsibilities

• Review medical documents, policy documents, policy history, claims history, system notes and apply the trained client level business rules to ensure that processors make appropriate Claims decisions, call out claims trends and flag fraud activities.
• Developing and maintaining a solid working knowledge of the insurance industry and of all products, services and processes performed by Claims function
• Perform functional analysis of the current business process and supporting documentation Identify process improvements and facilitate reengineering of business processes
• Create process and value stream map for existing and new business processes
• Assist in establishing and maintaining standard operating procedures and knowledge transfer documentation on various functionalities.
• Be a team player and work seamlessly with other team members on meeting customer goals.

Key Metrics

• Audit Productivity
• Accuracy
• Feedback% automated or mistake proofing done.

Qualification

Any Bachelor's degree,

Experience

A minimum of 3-5 years of experience as a Transactional Quality Auditor/MIS specialist/Quality associate involved in implementation of basic Quality framework elements.

Experience with Life Insurance Claims and Policy Administration.

Minimum Skills

• Demonstrates a strong understanding of claims business process redesign/reengineering, gap analysis, functional vs technical specifications, and change management.
• Ability to collate data/information from different sources and work on Management Reports without any error.
• Strong understanding of claims business process redesign/reengineering, gap analysis, functional vs technical specifications, and change management. Excellent communication skills (written and verbal) to clearly articulate business requirements to technical & development teams.
• Knowledge of process mapping tools - MS Visio and Lucid Charts, Excel and Power Point.
• Lean Six Sigma
• Experience working in an Agile environment.
• Experience with Salesforce or other case management systems' modernization.

Work hours from 9:00 pm to 6:00 am PST (Mon - Fri) from NttData Office at Manila. Additionally, resources may have to do overtime and work on weekend's basis business requirement."