Job Summary
We are seeking a collaborative and multicultural team player to efficiently investigate and process claims, administer medical subscriptions, and provide business support across the organization.
Duties and Responsibilities
1. Claims:
* Assess and process claims within the PPI portfolio according to relevant policy terms and conditions.
* Process and decide on claims over delegation for all businesses based on recommendations from TPA and relevant policy terms and conditions.
* Provide customer service for inbound and outbound calls.
* Check monthly reporting per partner for accuracy and completeness.
* Review claims transfer request forms and sign off monthly/weekly for accuracy.
* Propose process improvements for claim investigation and settlement.
2. Complaints Management:
* Assist in managing and reporting complaints when the Complaints Analyst is unavailable.
* FOLLOW THE COMPLAINTS PROCEDURE.
3. Business Support:
* Assist in creating and updating claims and subscription procedures as needed.
* Ensure all business documentation is up-to-date, filed, and archived.
* Present suggestions for reviewing and updating procedures to the Team Leader and implement upgrades.
* Maintain regular and ad-hoc reports and provide to the Team Leader.
4. Partner Management:
* Provide customer service support for business portfolios according to SLA.
* Travel to operational visits with the Team Leader/Operations Manager.
* Liaise with partners to provide follow-up trainings and clarify operational queries.
5. Projects:
* Participate in projects related to market implementation, new product administration, and partnership administration.
* Undertake training for day-to-day business, new partnerships, and products.
Requirements
* English and French language proficiency; additional European languages an advantage.
* Excellent customer relations and communication skills.
* Customer-facing experience.
* Relevant qualifications (degree or insurance qualification) advantageous but not necessary.