VACANCY: Medical Service Advisor– Egypt
For a Multinational Insurance Company
Experience: 0-2 yrs
Language: Excellent English Language is a MUST
Job Purpose:
To provide excellent service to members, group secretaries, intermediaries and providers reflecting agreed business service standards for all queries and complaints received by telephone, letter, email, member visits or fax
Requirements:
• 12 months experience within a servicing environment or similar is preferable.
• A third language other than English and Arabic is desirable
• Medical knowledge is required.
• Excellent problem solving and prioritisation skills, with close attention to detail and initiative are essential, together with the ability to make sound business decisions.
• Recognise and challenge possible fraudulent information and proactively seek to clarify and resolve using best method of communication and initiative.
Duties:
• Deal with members’ telephone enquiries, evaluate the situation and apply business criteria and detailed knowledge of Company International products to make appropriate decisions.
• The team member will be expected to take ownership and seek to resolve queries from our members, Intermediaries, group secretaries and providers via letter, fax, emails, telephone calls and face to face contact.
• In order to resolve queries the team member will be required to liaise, negotiate and coordinate with other teams to ensure customer focused action.
• The team member will be expected to establish and develop effective relationships by managing a regional portfolio of business customers.
• Provide support to other Company International offices/departments to overcome cultural and language barriers.
• Take responsibility for ensuring that the system records reflect up to date communications with external and internal customers so that the enquiries are documented and record to high standard.
• Achieve customer – focused decision making using judgment skills and utilizing agreed authority levels.
• Use agreed levels of authority and previous experience to make effective business decisions.
• Liaise with Care Management (UK), Health Services, and International Claims department where appropriate.
• Liaise with the clinicians and medical policy team to make appropriate decisions regarding preauthorization requests
• To provide feedback and recommendations for business improvements on preauthorization processes and procedures. To monitor the effect of any recommendations.
• To investigate statements of out-standing accounts from Egyptian participating hospitals.
• To produce reports providing relevant information to Claims and Health Services.
• To make sound business decisions regarding ex-gratia payment.
• Always providing the customers with clear information and suitable advice which takes account of their circumstances
• The team member will be expected to provide a pro-active service at all times
• The team member may be asked to take part in visits to Intermediaries or groups. The team member must be able to handle challenge during these visits and be able to deliver on any promise made to the intermediary or group.
• The team member must have a focus on sales and support their colleagues in making new sales and completing renewals.
• The team member will be expected to assist with the workload of other teams in the department according to their skills and development needs. In addition the team member will be called upon to train and mentor new members of the team depending on experience and knowledge.
• The team members may be required to provide training and support to intermediaries including the use of our websites.
• The team must adhere to the documented Best Practice Procedures and ensure that they are followed at all times.
• Taking charge of tracking lost cheques and request reissue of payments.
• Cancelling the HSBC Egypt cheques at the bank by filling the indemnity form and vice versa requesting to cancel indemnity forms at the bank if a stopped cheque needs to be cashed.
• Taking charge of tracking claims lost from logging and ensuring they are logged and assessed urgently.
• Deal with claims queries or adjustments and tracking claims’ payments.
• Coordinate with Service Partners to set medical treatment appointments for members seeking treatment internationally.
• Ensure that the team objectives are met throughout the year.
• Ensure that their performance reviews are in place before the agreed time with the team leaders.
• Acting as a main channel of communication between other Company Egypt departments and members, intermediaries and providers
• Supporting the claims teams in Egypt and Brighton to request medical reports from members, brokers or providers.
INTERESTED? PLEASE SEND UR RESUME in word format CV@blue-cons.com and put “Medical Service Advisor” in the subject line!
############## WARNING ##################
Please don’t send your resume if it is irrelevant to the above OPPORTUNITY. If you insist, to send your resume, please PUT your CURRENT TITLE in the subject line, otherwise, Your Resume WILL GET DISCARDED.
