Senior Process Consultant

Sagility is a leading organization that integrates advanced technology and transformation-driven BPM services with extensive healthcare domain expertise to enhance the member and patient experience. With over 25,000 employees across five countries, Sagility offers a wide range of services including clinical support, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. The Senior Process Consultant plays a vital role in contributing to team performance and profitability by executing action plans designed to improve and sustain client satisfaction.

Key Responsibilities:
- Apply foundational knowledge of Revenue Cycle Management (RCM) focusing on Accounts Payable/Accounts Receivable (AP/AR) with voice-based interaction.
- Demonstrate strong analytical and reasoning skills to address process requirements effectively.
- Communicate fluently in the required language for the assigned function or location, utilizing active listening and influencing skills.
- Manage claims processing, including handling incoming and outgoing calls, and take appropriate actions in line with process guidelines.
- Adhere to professional standards, policies, and procedures before making decisions or taking action.
- Maintain customer satisfaction by meeting turnaround times (TAT) and quality standards as per client Service Level Agreements (SLAs).
- Utilize company policies to resolve customer issues promptly or escalate them to management when necessary.
- Accurately input and update customer data in the company platform to ensure records are current.
- Handle multiple administrative and customer service tasks, including reviewing, investigating, adjusting claims, and managing remittance or denial processes.
- Commit to customer satisfaction by making quick, accurate decisions and providing effective solutions.
- Mentor and coach new team members as required, acting as a subject matter expert.
- Identify alternative solutions for problems, making decisions based on logical reasoning and relevant information.
- Take ownership of work activities and coordinate efforts within the team to achieve goals.

Required Qualifications:
- Any graduate degree.
- 2-3 years of experience in RCM AP/AR with voice-based processes.
- Strong understanding of medical terminology and coding.
- Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).
- Excellent attention to detail and accuracy.
- Strong written and verbal communication skills.
- Demonstrated leadership and problem-solving abilities.
- Ability to work independently and collaboratively within a team environment.

Preferred Qualifications:
- Knowledge of US healthcare regulations such as ERISA, HIPAA, and State Mandates.
- Familiarity with process SLAs and quality standards.
- Awareness of ISO and Information Security Management Systems (ISMS).
- Professional telephone etiquette and effective communication skills in English.
- Typing and general computer skills to support efficient workflow.

Location:
Hyderabad, India

This role offers an opportunity to work within a dynamic healthcare BPM environment, contributing to process improvements and client satisfaction while developing leadership and subject matter expertise.