Job Description
Key responsibilities / What you do:
- Manage the assigned tasks related to medical assistance cases.
- Evaluate medical claims according to the guidelines.
- Coordinate with different providers to ensure high quality of service when organizing medical assistance.
- Respond inbound and outbound telephone / e‑mail Customer / Partners inquiries and ensure call quality monitoring
- Claims evaluation and processing activities such as checking policy, eligibility, claims creation in the system, follow up upon ongoing claims ensuring the requested turn around time and processing of claims and other tasks related to claims management
- Assist callers on claims process / procedure / network inquiries, explaining policy terms & conditions
- Accommodates Business Units / Travel / TPA International requests with regards to opening international files, placement of Guarantee of Payment, etc.
- Follow the complaints & escala...
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