Job Summary

We are looking for an experienced and motivated Team Leader – Assistance Health Claims to lead our Overseas Health Claims team in Mauritius. The successful candidate will oversee daily operations, ensure efficient management of international health claims, coordinate with overseas service providers, and drive continuous improvements in service delivery. This role requires strong leadership, operational excellence, and a customer-focused approach to ensure members receive timely and high-quality support during overseas medical treatment.

Main Responsibilities

§  Lead, coach, and develop the Overseas Health Claims team to achieve operational and service excellence.

§  Manage the day-to-day operations of the overseas claims function, ensuring timely and accurate claim processing.

§  Oversee cluster performance and lead projects aimed at improving operational efficiency and customer experience.

§  Monitor the team email inbox and maintain accurate operational logs to track the status and progress of all overseas cases.

§  Supervise SOA providers and international healthcare partners, ensuring compliance with agreed service levels and quality standards.

§  Review and approve overseas treatment requests in accordance with company policies, medical guidelines, and delegated authority limits.

§  Take ownership of member complaints, ensuring prompt investigation, resolution, and effective communication with all stakeholders.

§  Ensure all claims and related activities comply with internal policies, regulatory requirements, and agreed turnaround times.

§  Coordinate regular follow-ups with members receiving treatment abroad to ensure continuity of care and timely case updates.

§  Prepare operational reports, analyse performance metrics, and recommend process improvements.

§  Collaborate with internal departments, healthcare providers, insurers, and external partners to facilitate seamless case management.

§  Support business continuity initiatives and contribute to departmental projects as required.

Job Requirements

§  Bachelor’s degree in management, Insurance, or a related field.

§  Minimum of 3–5 years' experience in health insurance, medical assistance, claims management, or a related field.

§  At least 2 years' experience in a supervisory or team leadership role.

§  Experience managing overseas medical claims or international healthcare providers will be a strong advantage.

Interested candidates are requested to send their CV on [email protected]