The Quality Team Leader will lead quality assurance in the CSC Email Review process, ensuring compliance, providing feedback, and driving improvements.
Description and Requirements
US QA CSC Email Review
Position Title:
Quality Team Leader
Reports to (Responsibility Level): UM/Manager -Quality
Supervises: NA
Location:
Jaipur
Global Grade:
GG -10
Complexity: C5T5
PID/s Load Mapping:
N/A
Position Summary
The Quality Reviewer will be responsible for leading the quality assurance function within the CSC Email Review process. This role involves reviewing and analyzing claim submissions, ensuring adherence to policy provisions, and maintaining high standards of accuracy, compliance, and customer service. The Quality reviewer will also provide feedback, coaching, and performance insights to the claims team, drive continuous improvement, and collaborate with internal and external stakeholders to resolve escalations and enhance process efficiency.
Job Responsibilities
Quality Review & Analysis
• Conduct detailed QA reviews of CSC Email submissions across multiple coverages and complexities.
• Ensure claims are adjudicated in accordance with policy provisions and regulatory guidelines.
• Identify errors, inconsistencies, or gaps in claim documentation and adjudication.
• Analyze trends in claim processing errors and provide actionable insights.
Feedback & Coaching
• Provide structured feedback to claim examiners based on QA findings.
• Coach team members to improve accuracy, compliance, and customer service.
• Mentor new hires and support their onboarding and training.
Performance Monitoring & Reporting
• Prepare and analyze performance scorecards and quality metrics.
• Generate custom reports from various data sources to monitor team and individual performance.
• Review and interpret QA data to identify areas for improvement.
Process Improvement & Compliance
• Recommend process enhancements based on QA findings and root cause analysis.
• Ensure compliance with internal policies, external regulations, and information security standards.
• Support UAT (User Acceptance Testing) for system enhancements and workflow changes.
Stakeholder Management
• Handle escalations from internal teams and external customers with professionalism and urgency.
• Collaborate with onshore management and client representatives to ensure alignment and transparency.
• Participate in client interactions and represent the QA function in governance forums.
Workforce & Team Management
• Support workforce management activities including scheduling, staffing, and attrition control.
• Motivate and engage team members to achieve quality and productivity goals.
• Ensure team members understand their goals and how they align with organizational quality objectives.
Education, Experience, Skills & Other Critical Requirement
Education
Bachelor's degree (Any Stream) with a minimum of 15 years of education.
Experience
(In Years)
Professional with 5+ years of work experience
Skills
Other Critical Requirements Like Voice/ Non-Voice for Insurance Ops
Complexity Scale: C5T5 (Domain SMEs, Good communication skills and ability to coordinate with multiple stakeholders via email/calls)
About MetLife
Recognized on Fortune magazine's list of the "World's Most Admired Companies" and Fortune World's 25 Best Workplaces™, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible . Join us!
#BI-Hybrid
US QA CSC Email Review
Position Title:
Quality Team Leader
Reports to (Responsibility Level): UM/Manager -Quality
Supervises: NA
Location:
Jaipur
Global Grade:
GG -10
Complexity: C5T5
PID/s Load Mapping:
N/A
Position Summary
The Quality Reviewer will be responsible for leading the quality assurance function within the CSC Email Review process. This role involves reviewing and analyzing claim submissions, ensuring adherence to policy provisions, and maintaining high standards of accuracy, compliance, and customer service. The Quality reviewer will also provide feedback, coaching, and performance insights to the claims team, drive continuous improvement, and collaborate with internal and external stakeholders to resolve escalations and enhance process efficiency.
Job Responsibilities
Quality Review & Analysis
• Conduct detailed QA reviews of CSC Email submissions across multiple coverages and complexities.
• Ensure claims are adjudicated in accordance with policy provisions and regulatory guidelines.
• Identify errors, inconsistencies, or gaps in claim documentation and adjudication.
• Analyze trends in claim processing errors and provide actionable insights.
Feedback & Coaching
• Provide structured feedback to claim examiners based on QA findings.
• Coach team members to improve accuracy, compliance, and customer service.
• Mentor new hires and support their onboarding and training.
Performance Monitoring & Reporting
• Prepare and analyze performance scorecards and quality metrics.
• Generate custom reports from various data sources to monitor team and individual performance.
• Review and interpret QA data to identify areas for improvement.
Process Improvement & Compliance
• Recommend process enhancements based on QA findings and root cause analysis.
• Ensure compliance with internal policies, external regulations, and information security standards.
• Support UAT (User Acceptance Testing) for system enhancements and workflow changes.
Stakeholder Management
• Handle escalations from internal teams and external customers with professionalism and urgency.
• Collaborate with onshore management and client representatives to ensure alignment and transparency.
• Participate in client interactions and represent the QA function in governance forums.
Workforce & Team Management
• Support workforce management activities including scheduling, staffing, and attrition control.
• Motivate and engage team members to achieve quality and productivity goals.
• Ensure team members understand their goals and how they align with organizational quality objectives.
Education, Experience, Skills & Other Critical Requirement
Education
Bachelor's degree (Any Stream) with a minimum of 15 years of education.
Experience
(In Years)
Professional with 5+ years of work experience
Skills
- Good knowledge of MS Office Suite
- Good computer navigation skills with keyboard speed
- Proficient in Email Management
- Knowledge of Insurance principles in relation to the US Insurance industry
- Strong knowledge of Quality function, Sampling method, root cause analysis, 7 QC tools.
- Communication skills - should be able to read, interpret business documents.
- Good verbal/written communication
- Proficiency in English - Spoken and Written
- Analytical and interpersonal skills
- Escalate issues if required
- Data gathering ability/ Eye for detail
- Teamwork/ Managing Self / Adaptability
- Adaptability to change
- Self-disciplined and result oriented
- Ability to multitask
Other Critical Requirements Like Voice/ Non-Voice for Insurance Ops
Complexity Scale: C5T5 (Domain SMEs, Good communication skills and ability to coordinate with multiple stakeholders via email/calls)
About MetLife
Recognized on Fortune magazine's list of the "World's Most Admired Companies" and Fortune World's 25 Best Workplaces™, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible . Join us!
#BI-Hybrid
Top Skills
7 Qc Tools
Email Management
Insurance Principles
Ms Office Suite
Quality Function
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Top Skills:
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