Claims Subject Matter Expert

• Review and validateCS - Service Claim Management procedures and work instructions, make sure all changes are correctly approved by authorized associates.

• Address any process unclarities, inefficiencies, doubts and roadblocks reported by operational team to correct stakeholders.

• Support CI initiatives in CS - Service Claim Management roadmap to enable automation and process excellence.

• Promote standardization of operations across systems and countries, make sure the exceptions are limited to minimum; define standards and maintainstandardization matrix; support initiatives to ensure improvement. 

• Support implementation of new tools and systems by performing testing, preparing teaching and training materials in collaboration with BPO and internal/ external stakeholders.

Quality & Compliance

• Make sure that BPO acts in compliance with BD process, policies and quality standards. 

• Perform quality and consistency checks

• Address any quality or compliance issues that are reported for claims processes 

• Ensure SOX controls are timely executed by BPO and QTC-GBS stakeholder, and evidence is available (price override spot checks), support all audit actions as per requirements

• Support internal and external audits

Process performance & governance:

• Report, analyze and monitorclaims and CS metrics to detect process gaps.

• Collaborate with BPO, CS Teams and stakeholders to address these gaps and take proactive actions to close identified deficiencies.

• Perform root cause analysis in case of escalations or KPIs below the agreed targets on the regional or country level. Support preparation and validation of improvement plan. Monitor progress and report on risks and issues.

• Support the claims governance implemented, monitortimely actions and accuracy of root cause analysis. Organize regular Gemba to make sure root causes are correctly defined and addressed.