Client Background: Belgium MNC- one of the largest health service organizations with 60 million customer relationships across the world and support this with a worldwide staff of 30,000 employees.
Industry: Insurance Service Provider
Remuneration: RM350 Convenient Allowance, Incentive, Performance Bonuses, Flexi Working Hours and 3months Maternity Leave & more.
Outline of the Role:
You will have all of the skills, knowledge and experience of a Customer Service or Claims Advisor. However, we’re looking for more than that - you will have a real desire to use your knowledge to help drive our customer experience to a new level.
You will use all of your knowledge and experience from a Claims & Customer Service background to drive a real ‘Category of One’ experience. Your understanding of the customer journey will ensure that your customer queries are resolved at point of contact. This will be demonstrated in a high first time resolution score.
Main Duties / Responsibilities:
• Adjudicate international medical, dental and vision claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals.
• Identify claims where further information is required working towards SLA and timescales.
• Monitor and highlight high cost claims and ensure relevant parties are aware.
• Monitor turn-around-times to ensure your claims are settled within required time scales to meet client SLA’s.
• Identify potential process improvements and make recommendations.
• Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first contact resolution where possible.
• Actively support other team members and provide resource to enable all team goals to be achieved.
• Manage customer instructions through the development of high quality interpersonal skills.
• Achieve personal and team productivity and quality goals.
• Ensure work is prioritized effectively.
• Work across European businesses and closely with other departments in line with service needs.
• Interface effectively with internal and external businesses to resolve customer issues.
• Carry out other adhoc tasks as required meeting business needs.
• Performs research to respond to inquiries and interprets policy provisions to determine most effective response.
• Flex between all of the above activities based on current customer demand.
• Flex your working shift based on current customer demand.
• A minimum of 12 months experience in medical administration, claims environment or customer service focused organization.
• Ability to meet/exceed targets and manage multiple priorities.
• Proficient in Microsoft Office applications.
• Case and Claims management system experience.
• Preferred if English and Arithmetic qualifications gained.
• Preferred language: Fluent in English. Other languages like French, German, Dutch, Spanish, Russian, etc. will be useful.
• Must possess excellent attention to detail, with a high level of accuracy.
• Strong interpersonal skills with good verbal and written communication to internal and external clients. This will incorporate call handling skills.
• Confident in making decisions and exercise judgment where necessary.
• Strong customer focus with ability to identify and solve problems without supervision.
• Ability to work under own initiative and proactive in recommending and implementing process improvements.
• Ability to organise, prioritise and manage workflow to meet individual and team requirements.
• Ability to maintain high levels of customer satisfaction by dealing with member/client enquiries in an effective and timely manner is essential for this role.
• Ability to adapt to change depending on requirements.
• Self-starter and able to motivate others.
• Ability to exercise judgment.
If you are interested in the position, kindly apply directly online by clicking on the “Apply” button. Thank you.