ROLE PURPOSE:

To support the membership and claims process by aligning all sales objectives for C&M with operations in order to meet service and quality standards set by Bupa Arabia and satisfy customers within regulatory guidelines.



KEY ACCOUNTABILITIES:



1. Operations

• Work with sales management team on target alignment to ensure on-time fulfillment delivery as per BUPA service and quality standards.

• Work with Regional sales team on all fast track requests for C&M and liasoning with Regional C&M teams to ensure delivery.

• Represent the claims & membership department all sales forums on all relevant business projects and operational issues e.g provider complaints, change requests, technology projects.

• Provide critical claims Information and respond to all information queries on claims & membership(C&M) to sales team.



2. Internal Controls

• Explain & align sales team on the validity of membership and claims policy rejections.

• Visibility on of re-imbursment claims benchmarks and CCHI guidelines to sales.

• Establish effective control processes & quality assurance in all interface processes on data between sales and membership/claims.



3. Process improvements & efficiency

• Support process improvements in the claims and membership area with sales through system enhancement and company performance initiatives to develop the most efficient processes for claims and reduce costs.



4. Service Strategy

• Continuously strive to improve the customer membership & reimbursement experience utilizing the in company focus groups to identify ways to improve the process.

• Discuss membership and statement rejections with sales/Provider relations in order to work together on aligning customer/provider practices with Bupa policies.


Job Details






















Date Posted: 2015-04-06
Job Location: Riyadh, Saudi Arabia
Job Role: Other
Company Industry: Healthcare, other


Preferred Candidate














Career Level: Management
Degree: Bachelor's degree


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