Senior Customer Assistant - Health Insurance (2419-SCAHI)
- Port Louis
- Negotiable
- Permanent
- Added 08/05/2024
- Closing 07/06/2024
- Human resources
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Our client in the financial sector is currently seeking to recruit a Senior Customer Assistant - Health Insurance who will handle claims intimation to settlement. The successful candidate will also participate towards achievement of set targets.
Responsibilities:
- Attend to clients and intermediaries and to provide technical advice regarding Medical claims.
- Ensure that all set targets are met within defined timeframes.
- Assist in the compilation of data and statistical reports.
- To handle claims efficiently from notification to settlement and effect payments as per terms and conditions.
- Compile and process claims received within KPI.
- Gather all supporting documents and other relevant information for claims settlement.
- Verify claims against coverage given and other terms and conditions.
- Follow up with internal Department in case of queries.
- Follow up on non-valid claims.
- Gather information for Incomplete & Non-Valid claims and request for missing information.
- Check outstanding premiums prior to settlement of claims.
- Provide assistance to Customers/Brokers/Agents on 'Terms & Conditions', medical protocol and remaining balances.
- Assist walk in clients for their claims submission for complex cases.
- Interact with the Accounts Department for rejected funds for payment made by Direct Credit.
- Prepare letters (Chronic/Non-Valid/Repetitive/Incomplete/Long Term/Notice).
- Provide assistance to the medical insurance team when required.
Profile:
- Either School Certificate or GCE O Level with credit in at least 5 subjects including English Language, French and Mathematics plus HSC/GCE A Level in at least three subjects (3 Main) or equivalent (IB, Baccalaureate). OR
- Part Professional qualifications progressing towards completion (at least Diploma level) of ACII. OR
- At least a Diploma in a related field of competence.
- 3-year relevant working experience.
- Good understanding of common health insurance industry practices, concepts and procedures.
- Proficient in Microsoft Office applications (Excel & Word).
- Good rapport building and interpersonal skills with strong negotiating and influencing skills.