Margreth Pillas Lu

Responsibilities as Policy Administration Coordinator:

• Coordinators organize and arrange the Policy information from the company’s Client.
• Ambiguities have to be cleared before the eligibility installation. Circulates the Benefit schedule to all the concerned in the Company. Update the premium and TPA fee in the system for generating various reports such as revenue, loss ratio, etc.
• Policy premium should be entered and check/verify before policy validation.
• Since the whole company relays on the Data the Coordinator catch and update in the system this Job demands for thoroughness or accuracy.
• Support others by doing endorsements (i.e deletions of members, additions of members and change category or plan).

List of specific tasks & behaviors that define successful performance & competency:

• Acknowledge Policy Information for all Individual, SME and Group Policy before setting up in the system.
• Clear ambiguities
• Policy Installation (i.e set Plan/products/contracts & Policy parameters)
• Update Table of Benefits and upload to respective Product. Save the data for the records.
• Intimate Production Coordinator (Census Management), that system is ready for accepting the beneficiaries. Any special notes to be printed on the card or update in the system shall be also intimated.
• Validate the Policy once above process is complete after verifying the premium computation with the Payer.
• Revisions and modifications to the policy benefits and conditions shall be updated quoting the modified date
• Any deviation from the procedures in place, requested by the Payer shall be notified to the Supervisor and get approval before proceeding.
• Organize and save all email communications for verification and audit.
• Coordinate with all departments and clarify the discrepancies related to policy information, if required.
• Assist and motivate the colleagues.
• Maintain agreed TAT (turn-around-time) and good relation with all the concerned in the Business.
• Should be presentable in all aspects.

Duties and Responsibilities as BPO:

• Assigned processor for applications, enrolments, billings and claims for one of the biggest insurance company in the US.
• SME Level 1 (Subject Matter Expertise). Support the teams by answering their questions and other concerns in terms of processing the transactions.
• Quality Assurance support. Help the QA by updating the teams regarding the processing issues and concerns.
• Submit reports on the given time such as Quality Improvement Plan (weekly), Individual Performance Plan (monthly) and My Learning (monthly).
• Assigned to conduct weekly exercises like games, quizzes and other activity to avoid pressures and stresses.
• Update files for client’s Policies and Procedures.
• Helps organizations become high-performance businesses and governments.
• To help other companies to transform the way their business works.
• To perform the core values in a simple way.