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February 26, 2020
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Home » Medical Assessor – Insurance Approval at WARBA Insurance – Al Kuwait – Kuwait Jobs

Medical Assessor – Insurance Approval at WARBA Insurance – Al Kuwait – Kuwait Jobs


Job Description

Position Summary:
Primary point of contact for the customers for all aspects related to pre-approvals/health benefits/claim status and other queries
Roles and Responsibilities:
o   Assess and Analyze clinical information and medical evidences presented by medical providers
o   Respond, approve or reject medical claims based on the policy holder table of benefits in a timely manner
o   Give verbal and or written justification in case of rejection to provider and or policy holders in a professional manner
o   Understand and follow the escalation matrix in case of complicated medical cases and or when the claim exceeds the authorized limit
o   Communicate with customers through calls / emails and assist them with their inquiries.
o   Redirect calls / emails to the concerned departments.
o   Identify customer’s needs, clarify information, research every issue and provide solutions and/or alternatives
o   Keep records of customer’s complaints/suggestions/comments, as well as actions taken
o   Managing large amounts of inbounds and outbound calls in a timely manner
o   Maintain the required quality for the process (Greeting – Phone Etiquette – Transferring Calls)
o   Following communication “scripts” when handling different topics
o   Ensure accuracy of the information provided to customer, request support from team leader if required
o   Report cases that requires further follow-up by supervisor and keep customer informed with feedback
o   Escalates customer issues and complaints to CSM within 24 hrs using proper documents to address the issue.

Skills

Background/Experience
o   0-6 years’ experience in customer service preferably in the medical field
o   University Graduate from the medical field
o   Arabic Speakers with Good Command of English Language is a MUST
o   MS Office skills
o   Communication: the ability to communicate information and ideas in spoken and written words so others will understand
o   Critical Thinking: using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approach to problems
o   Service Orientation: actively looking for ways to help people
o   Time Management: ability to plan, priorities and multi-task
o   Collaboration and Teamwork: ability to interact effectively
o   Influencing – Strong Communication, persuasive and negotiation skills
o   Flexibility and ability to adapt quickly to changing priorities
 
Additional Skills
o   Awareness about health insurance would be added advantage

Job Details

Job Location
Al Kuwait, Kuwait

Company Industry
Other Healthcare Services

Company Type
Employer (Private Sector)

Job Role
Medical, Healthcare, and Nursing

Employment Type
Full Time Employee

Monthly Salary Range
Unspecified

Number of Vacancies
Unspecified

Preferred Candidate

Career Level
Mid Career

Residence Location
Kuwait

Degree
Bachelor’s degree / higher diploma

Education

Bachelor’s degree in a medical field



Click here to apply

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