- Conducts regular client visits to engage corporate clients of HMO and group life insurance plans to proactively manage service issues, offer wellness programs, provide product updates, and build strong relationships.
- Handles calls/queries/requests from Business Partners regarding HMO and insurance products benefits procedures, claims, and other customer concerns. Handles priority requests of VIP's and special clients, from time to time.
- Coordinates with service providers on the resolution of issues and concerns raised by Business Partners regarding HMO Plan and group life insurance benefits and coverage.
- Ensures that digital marketing assets are circulated to Business Partners, including advisories, information posters, special greetings. Contributes to the development of content of digital marketing assets.
- Handles queries received through the CAD Hotlines.
- Promotes, sells and administers wellness services and programs, including client-based annual medical exams, wellness and health lectures, Executive Check-Ups and others
- Updates Client Portal such as updating the status of card issuance.
- Handles processing of medical claims based on schedule of benefits, within agreed turnaround time (TAT)
- Maintains an updated database of claims received, processed, approved and disapproved and sends these reports to Business Partners weekly, including membership cards, membership certificates, and the like (e.g., group life / personal accident certificates).
- Requests periodic utilization reports from various service providers as basis for preparation of comprehensive benefit management reports (claims loss ratio, utilization cost drivers, etc) , Experience Discount/Refund if applicable, etc)
- Prepares monthly benefit utilization report and related management reports
- Participates in client meetings to discuss claims decisions, updates and procedures
- Processes Medical Collectibles received from HMO providers before endorsing to FAD for billing.
- Performs related functions as deemed necessary by the Company
Job Type: Full-time
Pay: Up to Php20,000.00 per month
Benefits: - Company events
Health insurance Opportunities for promotion
Schedule:
Monday to Friday
Supplemental Pay: Bonus pay
Expected Start Date: 09/16/2024
