DUTIES AND RESPONSIBILITIES
Working with a collaborative and multicultural team to efficiently investigate and process claims, and administer the validation of medical subscriptions, implementing streamlined processes and procedures and provide business support on all operational aspects throughout the organisation.
Claims:
- Assess and process claims within the PPI portfolio according to relevant policy terms and conditions.
- Process and decision claims over the delegation for all businesses based on recommendation received from TPA and according to the relevant policy terms and conditions. Confirm approval to TPA.
- Provide customer service for inbound and outbound calls.
- Check monthly reporting per partner for its accuracy and completeness.
- Check Claims transfer request forms and sign off monthly/weekly confirming accuracy.
- Propose process improvements to the processing investigation and settlement of claims.
Complaints management back up (if Applicable):
- To assist in the management and reporting of Complaints when complaints analyst is out of the office or if needed.
- To ensure and follow the complaints procedure associated.
Business Support:
- Assist in creating and updating claims, subscriptions procedures as and when necessary, for new and existing business.
- Assist the Team Leader in ensuring that all business documentation for the department is up to date, filed and archived.
- Present suggestions for reviewing and updating procedures to Team Leader and implement, coordinate, and monitor any upgrades to procedures as they are signed off.
- Maintain various regular and ad hoc reports and provide to your Team Leader.
Partner Management:
- To provide customer service support for the business portfolios according to SLA.
- Travel on Operational visits to partners with Team Leader/ Operations Manager ensuring prior organization by means of Agenda and Minutes to be circulated on return.
- Liaise with all partners in order to provide follow-up trainings and clarification on operational queries, understanding of policy wording and/or working processes via conference calls or emails.
Projects:
- Participate in any projects related to your market including but not limited to new product implementation and ongoing administering, new partnership implementation and ongoing administering.
- Training related to day-to-day business, training of new partnerships, new product training internally within the team/department or within the partnerships
Skills and Qualifications
- English and French - any other European languages an advantage.
- Good customer relations and communication.
- Experience in Customer facing roles
- Any relevant qualifications including degree or insurance qualification would be an advantage but not necessary
Morgan McKinley is acting as an Employment Agency and references to pay rates are indicative.
BY APPLYING FOR THIS ROLE YOU ARE AGREEING TO OUR TERMS OF SERVICE WHICH TOGETHER WITH OUR PRIVACY STATEMENT GOVERN YOUR USE OF MORGAN MCKINLEY SERVICES.
