Sr. Officer - Service Operations Support

·        Work with sales management team on target alignment to ensure on-time fulfillment delivery as per BUPA service and quality standards.

·        Handle all cases received from RM's with high quality and ensure proper resolution within the KPI's.

·        Liaise with required functional teams to resolve cases escalated by RM's.

·        Daily track/record of all pending and closed cases and monitor resolution time.

·        Establish effective control & quality assurance in all interface data processes

·        Collaborate feedback with the sales team for continuous improvement.

·        Review and resolve complaints that have been escalated by RM's

·        Record the complaints and share with the Quality team.

·        Discuss medical Pre-Auth and claims statement rejections with sales/Provider relations in order to collaborate in aligning customer/provider practices with BUPA policies

·        Support process improvements in the Pre-Auth and Claims processes with Sales in system enhancements and company performance initiatives to help develop the most efficient processes.

·        Continuously strive to improve the customer Pre-Auth and Claims experience by participating in focus groups to identify ways to improve the process

·        Assist in conducting database analysis and use results to improve processes and KPI’s.

·        Support in the creation of Dashboards for all Back Office activities and circulate them internally

·        Review all commercial and Ex-Gratia approval requests from RM’s and escalate to the authorized person in the authority matrix.

·        Process the approval through CAESAR while liaising with Pre-Auth and update the RM on the outcome.

·        Maintain and update the commercial budget records

·        Bachelors Degree in Business Administration, Finance Or Healthcare.    

·        Good analytical skills and planning capabilities

·        Multi-Cultural with very good communication skills

·        Deep understanding of CCHI & regulations

·        Knowledge in the insurance and medical terminology is a major advantage.

·        Service mindset

·        0-3 years