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Job Description
•Ensure high customer satisfaction in line with BUPA values and business strategy
•Ensure all cases adjudicated by the team is based on common medical practice and aligned with BUPA protocols and policy .
•Liaise with medical and non-medical staff at providers to ensure quality healthcare service for our members
•Maintain and update a database for the treating doctor and provider/hospital service delivery review of the customer experience based on clearly defined matrix and service levels
•Ensure compliance to SAMA and CCHI regulations during medical adjudication.
•Ensure achiving the daily Targets in term of productivity and speed answer for adjudicated requests
•Ensure proper interpretition and usage of clinical skills
Skills
•Minimum Bachelor degree in Medicine or equivalent whereas a Master degree in medicine/surgery is preferable
•Postgraduate in Medicine / Masters in Business Studies, preferable .
•2-5 years of experience at least in medical field ( Hospital practicing ) or at insurance field
•Excellent communication skills in both English and Arabic
•Leadership and Analytical skills
Education
MBBS/ Medicine
