Policy Admin - Technical Supervisor
Medivisa for Medical Claims Settlement (Member of MedGulf Group)
مجموع سنوات الخبرة :19 years, 11 أشهر
- Briefing of medical insurance policies with IOP system.
- Summarizing medical insurance policy benefits and exclusions according to the agreed terms & conditions between the Medgulf & Policy holder.
- Sending Policy Briefings to Assigned Providers Network List through Active Fax system according to the classification of the providers & classes of the insured members.
- Updating all policy related data (amendments, suspension, reactivation & cancellation) in our system.
- Classification of providers according to contractual agreements & filing the confirmations of each & every policy briefings from providers.
- Updating the Health Care Providers list according to the data received from Medgulf Network Department / Providers Affair.
- Updating MCA, Policy Summary, TPA notes and IMS.
- Handling communications with Health Care Providers for any policy briefing related issues.
- Providing technical support of policy related inquiries to other departments.
- Supervising and guiding Policy Admin support team.
- Training of newly joined staff
Handling communications with Health Care Providers for any policy briefing related issues.
✓ Providing technical support of policy related inquiries to other departments.
✓ Supervising and guiding Policy Admin support team.
✓ Briefing of medical insurance policies.
✓ Updating the Health Care Provider Status (Activation, Suspension, Upgrade / Downgrade,
Etc.) according to the data receiving from the provider’s affairs dep.
✓ Updating all policy related data (Endorsements, Amendments, Providers Addition /
Deletion, Etc.) according to the information received from the underwriter department.
✓ Summarizing Medical Policies according to the policy benefits and exclusions.
✓ Training of newly joined staff
Responsible for the day to day procurement requirements.
Maintain accurate records of all quotations and activities taken.
Lead, direct, coordinate, and manage all administrative aspects.
Maintain a diary of activities associated with quotations and procurement.
Prepare various statistical/financial/marketing analyses.
Orienting and guiding staff.
Arrange training sessions and organize teams.
Assisting and reporting directly to the HR manager
Conducting researches on employees satisfaction issues
Planning, organizing and arranging quizzes for different employees in different positions.
Handling all IT-related issues.
Ensure high standards of customer focus.
Serving the customers and able to maintain long-term relationship with them.
Actively pursues learning and development.
Cumulative G.P.A 2.9/4
Cumulative G.P.A 2.20/4