KEY DUTIES AND RESPONSIBILITIES
- Daily Intimating and/or log all medical claims on the medical application.
- Prepare and dispatch all Explanation of Benefits (EOB) to intermediaries, agents, and direct clients and policyholders.
- Ensure timely resolution of queries received daily within the medical department is completed as per established
service standards.
- Attend to all daily walk-in clients and call-in clients.
- Prepare and dispatch cheques daily to intermediaries, agents, clients, and policyholders. This includes cheque
payments to healthcare providers.
- File and upload all documents used electronically within the administration and claims function on the applicable
SharePoint site.
- Submission of cheque stubs to Head office for their records upon receipt.
- Prepare pickup forms for cheque disbursement to brokers and agents as required.
- Prepare coverage letters requested by clients and intermediaries within the established service standards and
turnaround time.
- Prepare guarantee letters to Healthcare providers as required for sign off by the Supervisor.
- Generate and prepare any reports (monthly, quarterly, semi-annually, annual, and/or ad hoc) for intermediaries,
agents, and clients, upon request or as required.
- Demonstrate a thorough knowledge of the Company’s products and procedures, and a good understanding of industry
regulations as it relates to the provision of information and services to clients.
- Provide prompt and quality Customer Service by projecting and demonstrating a high level of professionalism,
courtesy, and initiative in accordance with established service standards and policies.
- To perform any other job-related duties as assigned by Management.
KNOWLEDGE & EXPERIENCE
- Minimum 1-2 years’ working experience in an administrative function or medical environment.
- Must exhibit strong communications and interpersonal skills with the ability to effectively communicate with people at
all professional levels, specialties, and roles.
- Must be flexible, analytical, and organized in putting policy changes into practice.
- Good reading and writing skills.
- Clear written and verbal communication with both internal and external clients;
- An ability to work individually and as part of a team.
- Must show good planning, time management, and organizational skills, paying keen attention to detail and the ability
to focus for long periods.
- Demonstrates solid judgement and discretion working with confidential information.
- Deadlines focused; able to work under pressure to meet tight deadlines.