Interacts with multiple internal and external partners including providers, provider offices, and dentists to gather necessary information and clarify details to ensure correctness of records in various reference systems for claims processing. Responds to incoming calls from providers and makes outbound calls to providers, provider offices, and dentists with semi-scripted calling involving approximately 50% outbound and 10% inbound calls. Creates, updates, and maintains provider records in internal systems by conducting research in multiple systems to resolve discrepancies in provider information submitted claims versus referral systems. Validates and updates provider information including billing and rendering for accuracy, completeness, and eligibility according to established guidelines to support claim processing. Efficiently updates system logs based on calls and actions taken while efficiently accessing and navigating multiple applications including mainframes, PC, and Internet-based systems to gather and assess information. Coordinates with process associates in prescribed scenarios and performs additional essential functions as directed by the Supervisor in a consistent, professional manner while exercising strong verbal, written, and high-quality service skills.

Bachelor's degree in any stream or diploma with minimum 15 years of education is required. Must have 3-4 years of experience with minimum 12 months of calling background, preferably international, and customer service background in insurance or related industry is preferred. Excellent fluency in speaking and writing English with ability to interact and connect with providers over calls is mandatory. Must demonstrate excellent comprehension skills to interpret and analyze information from various resources with strong problem-solving abilities and appropriate responsiveness. Requires good computer navigation skills for multiple applications and comfortable working on 2 to 3 computer screens with excellent keyboarding and data entry speed. Must possess analytical skills with eye for detail to find discrepancies in information, ability to research and take decisions to resolve problems, and knowledge of insurance principles in relation to US Insurance industry is preferred. Must be self-disciplined, results-oriented, able to multitask, demonstrate ability to work independently and in team environment, and open to working rotational shifts with 5 days work from office.