• Manage and follow up emergency cases and process precertification requests for the assigned portfolio and handle pre-approval from both healthcare providers and clients.
• Treat requests according to authority limits.
• Report suspected fraud cases and any sort of complaints to supervisors/manager.
• Ensure the best customer service to providers, insured, coordinators, brokers.
• Sort the mailboxes and distribute these emails to the teams in charge.
• Analyze, suggest and recommend improvements in the work area.
• Handle queries related to policy benefits, claim status, network.
• Comply with the Turn Around Time of the unit and ensure it is followed throughout the operations.
1- Degree in medical field as pharmacy, nursing, anesthesia, kin..etc is a must.
2- Previous experience in customer service (délégué) or insurance industry mainly TPA is preferred.
3- Good communication skills in French, English and Spanich.
4- Ability and willingness to move to an administrative job (8 hours per day) and be in an indirect contact with patients.
5- Flexibility to work at night shift, during weekends and public holidays.