Senior CSA

© Firstsource Solutions Limited l Confidential | March 6, 2021 1

Job Description – CSA/Sr. CSA Non - v Oice

Firstsource Solutions is a leading provider of customized Business Process Management

(BPM) services. Firstsource specialises in helping customers stay ahead of the curve through

transformational solutions in order to reimagine business processes and deliver increased

efficiency, deeper insights and superior outcomes.

We are trusted brand custodians and long - term partners to 100+ leading brands with presence

in the US, UK, Philippi nes and India. Our rightshore delivery model offers solutions

covering complete customer lifecycle across Healthcare, Telecommunications & Media and

Banking, Financial Services & Insurance verticals.

Our clientele includes Fortune 500 and FTSE 100 compa nies.

Job Overview

A claims examiner needs to analyse multiple documents / contracts and decide to pay / deny

the claim submitted by member or providers with respect to client specifications. The claims

examiner should also route the claim to different department or provider / member for any

missin g information that required for claims adjudication. The claims needs to be completed

adhering to required TAT and quality SLA.

Key Roles And Responsibilities

• In - depth Knowledge and Experience in Claims Processing.
• Should have Excellent Analytical skills to review claims based on rules and workflows.
• Need good comprehension skills to adjudicate claims as per Policies and Procedures.
• Should be a complete team player
  
  

K Ey Performance Indicators

• Ensuring that the key Service Level Agreements are met consistently without any
  
  

excepti ons.

• Need to achieve set Production goals.
• Adherence to departmental and company rules and regulations.
  
  

R Eporting Structure

Sr Executive – Team Leader – Manger Operations.

Success Profile

Qualification & Experience :

Experience of 1+ year as an Claims Adjudicator.

G raduation is a must in any stream of Education