Responsible for producing and distributing various reports to physicians, hospitals and HMO's. Responds to customer and underwriter requests and answers questions from physicians regarding CRICO coverage and processes. Provides timely and efficient service to our member institutions, physicians and other members of the Underwriting (UW) team.
Key Duties & Accountabilities:
Completes requests for claims history, insurance confirmation documents, physician terminations and other reports in a timely manner with high quality
Provides telephone and email support for our physicians and other hospital personnel
Establishes effective relationships with credentialing personnel and other key members of insured organizations for the purpose of providing outstanding customer service
Communicates and collaborates effectively with other members of the Underwriting (UW) team as well as Claims, Patient Safety, Communications and other CRICO departments
Recommends modifications to underwriting guidelines and policies and procedures as needed
Recommends and implements ideas that improve efficiency, customer service and/or quality
Works with Senior UW and UW Leaderships to gain knowledge of CRICO policy language and coverage
Meets or exceeds service standards in the areas of new business, renewals, audits and confirmations of coverage and requests for information
Keeps management apprised of arising issues related to own job
Takes ownership for issues until resolved or owned by proper person
Adjusts activities to meet changing department demands
Questions workflow and processes and recommends improvements
Performs other related duties as required by position
Core Competencies:
Interpersonal/Collaboration/Teamwork
Clerical/Administrative
Communication
Customer Service
Knowledge, Education, Experience, & Skills:
Associate degree required; BA/BS degree or the equivalent preferred
Uses technical job skills and knowledge to find solutions to overcome obstacles or to create new ways of doing things
Makes sound decisions based on established guidelines
Confronts problems with tact and diplomacy
Solicits and considers the input and ideas of others
Develops collaborative relationships
Seeks out role models in order to learn and develop
Primary Contacts:
Exchanging routine information with coworkers in the department, outside the department or with clients/members or consultants or vendors.
Internal: Underwriting, Claims, Patient Safety
External: CRICO institutions, current and prior physicians and employees, other hospital systems
People Management: No direct people management responsibilities
Latitude/ Freedom to Act: Works independently with general direction and supervision
Key Performance Indicators (KPI's):
Quality and accuracy (minimal rework and errors)
Timeliness of work product
Reliability
Feedback from client group and business partners (focus on excellent customer service)