Responsible for managing Insurance related plans and processes, claims and coordination related matters for the Group of companies. Provide a range of administrative, and organizational support to the Medical & life department as well as the whole sales team. Manage and evaluate administrative requests from/within the department and ensure all are within corporate guidelines,
· Main work coverage includes Medical, life and Travel policies.
· Builds and maintains business relationships with clients by addressing their concerns, issues and queries related to policy, claims, network, approvals, benefits, including amendments.
· Assessing clients' current and future insurance needs.
· Provide relevant support to Manager including monitoring of deadlines and ensure that reports are completed on time.
· Manage all types of correspondence, requests, and inquiries.
· Refer all related requests to policy to ensure efficiency, minimizing errors and timely administration.
· Arrange insurance cover for clients with the insurance provider and ensure medical cards are obtained and delivered to clients within time frame.
· Claims handling process. Monitoring of claims, update clients list in a comprehensive manner; Check policies to ensure coverage of reimbursement claims (eligibility, submission, TAT, settlement, and payment).
· Provides detailed consultation to members regarding their benefit schedule or claims on dispute and overall coverage and exclusion.
§ Investigates, negotiates, and settles routine claims over the phone or by mail.
· Receives and evaluates claim documents from clients before sending out to insurance providers, checks any missing essential requirements which might cause delay, then requests it from client for a complete submission meeting the standard turnaround time.
· Provide assistance to internal request from Sales Team.
· Handles and operates portal access provided of insurance providers.
· Assist in comparison of benefits.
· Ensures premiums are paid and coordinate billing cases.
· Keep detailed computer records and secure documents requested for Audit; Prepares and upload files for documentation in the shared folder and other related record keeping.
· Other tasks as deemed needed by the department manager.
Skills and Experience
- Bachelor’s Degree of Science in Nursing is preferred.
- Proven insurance industry experience with individual and group insurance products.
- Excellent written and oral English communication skills
- Ability to work to tight deadlines and deliver results to short timescales.
- Good knowledge of Microsoft Office/other PC based applications
- Solid foundation knowledge of insurance claims processing.
- Commitment and energy for long-term challenging environment
- Knowledge of office procedures.
- Knowledge of data entry equipment and office practices and procedures.