Requirements:
Candidate must possess at least Bachelor’s Degree in any discipline or equivalent.
At least 3 year(s) of working experience in health/travel insurance and/or healthcare industries with exposure to underwriting, membership administration, claims, customer service, and/or training environment.
Excellent knowledge of health/travel insurance policy, underwriting, membership and policy administration.
Ability to perfrom in a research, analytical, advisory, and consultative role.
Excellent knowledge of all facets of medical or claims procedures, terminologies, payment analysis, and claims processins system.
Strong leadership and good communication skill.
Good command of both written and spoken English.
A professional ‘get it done’ attitude and work ethic.
Responsibilities:
Initiates and directs necessary action to develop and maintain process in the area of sales, policy/membership administration, claims processing systems and case management to allow all systems and inquiries are operated in a systematic manner.
Work with all areas to promote efficient process, enhance teamwork and gain an understanding of the entire adjudication process, including the use of technology to improve workflows.
Effectively communicate with customers, potential customers, and vendors to maintain strong work relationships and enhance the potential chances for future business.
Ensure all policies and memberships administration, call process and claim process meets the SLA.
Performs other duties or projects as assigned to contribute to the efficiency, effectiveness, and productivity of the division.
Accountable for daily operations to meet productivity or service standard as defined by management in line with department and/or division.
Meet the company KPI’s on monthly, quarterly, and yearly basis.
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