Checking job availability...
Original
Simplified
Key Responsibilities
Leadership and Management
- Lead, mentor, and develop the claims team, including claims managers, and supporting staff.
- Set performance goals, conduct regular performance reviews, and provide ongoing training and development opportunities.
- Foster a collaborative and high-performing team culture.
Claims Processing
- Oversee the end-to-end health claims process, ensuring timely and accurate processing of claims.
- Develop and implement policies and procedures to improve claims handling efficiency and effectiveness.
- Monitor and analyze claims data to identify trends, issues, and areas for improvement.
- Ensuring all claims are processed according to Policy Contracts and guidelines.
- Implement and maintain quality control measures to minimize errors and fraud.
Client Management
- Communicate effectively with clients and intermediaries to resolve issues satisfactorily within a reasonable timeline.
- Review and enhance work processes with internal and external stakeholders to improve customer experience.
- Handle escalated claims and resolve complex or disputed claims issues.
- Develop strategies to enhance the customer experience in the claims process.
Collaboration & Strategic Planning
- Collaborate with other departments, such as Contact Centre, IT and Project Management Team to ensure seamless operations and effective communication.
- Provide regular reports and updates to senior management on claims performance, trends, and key issues.
- Develop and implement strategic plans to improve claims management.
- Stay informed about industry trends, regulatory changes, and best practices in health claims management.
- Lead initiatives to adopt new technologies and innovations that enhance claims processing efficiency.
Key Responsibilities
Leadership and Management
- Lead, mentor, and develop the claims team, including claims managers, and supporting staff.
- Set performance goals, conduct regular performance reviews, and provide ongoing training and development opportunities.
- Foster a collaborative and high-performing team culture.
Claims Processing
- Oversee the end-to-end health claims process, ensuring timely and accurate processing of claims.
- Develop and implement policies and procedures to improve claims handling efficiency and effectiveness.
- Monitor and analyze claims data to identify trends, issues, and areas for improvement.
- Ensuring all claims are processed according to Policy Contracts and guidelines.
- Implement and maintain quality control measures to minimize errors and fraud.
Client Management
- Communicate effectively with clients and intermediaries to resolve issues satisfactorily within a reasonable timeline.
- Review and enhance work processes with internal and external stakeholders to improve customer experience.
- Handle escalated claims and resolve complex or disputed claims issues.
- Develop strategies to enhance the customer experience in the claims process.
Collaboration & Strategic Planning
- Collaborate with other departments, such as Contact Centre, IT and Project Management Team to ensure seamless operations and effective communication.
- Provide regular reports and updates to senior management on claims performance, trends, and key issues.
- Develop and implement strategic plans to improve claims management.
- Stay informed about industry trends, regulatory changes, and best practices in health claims management.
- Lead initiatives to adopt new technologies and innovations that enhance claims processing efficiency.