Senior Medical Insurance Representative
Arabia Insurance Company
Total years of experience :19 years, 3 Months
Administering procedures of medical insurance products and managing the same as per the service level agreements
Monitoring various processes for the verification of client information and enter it into the system
Collaborating with the Management and Third Party Administrator on claims issues and resolving them efficiently
Preparing and managing reports of productivity and providing assistance to the management
Maintaining all processes and filters, providing technical assistance to the entire work flow and maintaining communication in routine activities.
Corresponding with the agent or the insured to inform them or receive the information about the account status or alterations
Organizing and working with detailed office records and managing files for all new and existing corporate policy holders.
Processing and checking calculations of premiums, commissions, refunds, adjustments, etc.
Assisting and providing support to the customers in case of issues related to medical insurance
Resolving inbound calls from customers and providers and answering queries of potential customers
Identifying reimbursement discrepancies and making changes in them or correct them
Creating and monitoring unpaid claims as well as processing denial claims and appeals
Resolving issues related to payment
Collaborating and supporting other staff
Manage day-to-day HR related issues (Visa Concerns, Bank Issues, Recruitment, Attendance)
Act as the first point of HR contact for employees
Make and maintain records and information related to payroll
Maintain the administrative manuals and forms
Screen resumes and select the most qualified of them all
Answer queries such as those relating to the company's policies and benefits structure
Maintain the HR records by updating information about new recruits, promotions, changes in job titles, terminations, leaves, etc.
Compose and circulate routine correspondence from the HR Department
Provide support for the Human Resource Management Systems (HRMS)
Oversee administration of leave benefits like Maternity Leave, Short Term Disability Leave, etc.
Manage day-to-day leads generation activity by ensuring the information reliability from the Financial Executives
Evaluate activity levels of Financial Executives and recommend action plans for Area Sales Managers.
Oversee the Leads-Generating system and coordinates technical concerns to outsource partner.
Prepare Daily Activity Report submitted to Business Heads on Area Activity Levels and efficiency of the region.
Responsible for the Month End report submission of the Department after receiving data from all branches
Provide Area Sales Managers with reports needed in monitoring Leads Volume, Utilization, Completion and Compliance in the area
Monitors incentive payout due for the bank referrer.
Conducts training to Financial Executives to promote awareness on Leads and Activity Management guidelines and campaigns.
Initiates procedures after developing and examining data and records (Excel-Based)
Collaborates and communicates with manager and staff to have a closer relationship on our day-to-day activities.
FOR ACCIDENT AND HEALTH ACCOUNT:
Performs administrative functions of Accident & Health products including policy issuance of new and renewal accounts, monitoring of pending cases, billing of subsequent payments, handling of calls & customer service for existing policies.
Prepares Monthly Sales Report submitted to Department Heads including Underwriting, Actuary, Accounting, Marketing and Systems (Information Technology).
Computes for the production credits and bonuses of Financial Sales Executives qualified for existing Accident & Health promos.
FOR GROUP LIFE ACCOUNT:
Process Group Life policies including pre-underwriting of cases, preparation of policy contracts for new and renewal accounts, monitoring of pending applications and sending correspondence to Financial Sales Executive regarding the status of application.
FOR MEDICAL ACCOUNT:
Handles database maintenance of all active Medical Examiners and Diagnostic Lab/Clinic accredited by the company, prepares Letter Of Agreement for clients who will undergo Medical Exam and Memorandum Of Agreement for Medical Examiners and Diagnostic Lab who applied for accreditation and prepares check request for Medical Examiners conducting Medical Exam to clients.