Your everyday
- Daily monitoring of all medical claims.
- Manage the expectation of customers in line with Company’s direction
- Verifying claims documents vs policy terms & conditions to ensure genuineness of claim within policy coverage
- Coordinate between customers, service providers to ensure excellent service
- Coordinating with Accident & Health team for medical opinion and claim approval & ensure targeted turnaround time is achieved
- Performing medical contact to gather information from hospitals/medical center
- Explaining medical problems to patients or their families
- Reviewing the treatment provided by hospitals is relevant to the case and in appropriate price
- Flag irregular/fraudulent/exaggerated claims to superior for further action
- Liaising with hospitals with a view to eliminating unnecessary or irrelevant treatment, over-servicing, over-charging and cost-containment
- Evaluating customer’s condition and arranging proper assistance to claimant
- Handling e-mail & all communication channels within targeted timeline
- Prepare weekly reporting on TAT, outstanding & repudiated cases
- Any other task/responsibility assigned by superior
Your profile
- 1-2 years of nursing or nurse claim assessor experience.
- Experience working under the Insurance department in the hospital or insurance and broker will be a big plus.
- Have a flexible schedule and must be able to work in shifts which may include night schedule and weekend.
- Able to work in commercial environment and fast moving business
- Good interpersonal and communication skills
- Computer literacy is essential
- Self-motivated, result oriented, ability to work under pressure, creative and energetic
- Willing to learn and can do attitude
Skills Required
- 1-2 years of nursing or nurse claim assessor experience
- Experience working under the Insurance department in a hospital or with insurance/brokers
- Willingness and ability to work shifts including nights and weekends
- Ability to work in a commercial, fast-moving business environment
- Good interpersonal and communication skills
- Computer literacy
- Self-motivated, result oriented, able to work under pressure, creative and energetic
- Willingness to learn and can-do attitude
What We Do
sunday turns the tedious 15 minutes it takes to pay at a restaurant into a quick, simple experience that takes less than 10 seconds. You scan a QR code, pay, and walk away. In the meantime restaurateurs can focus on what matters for them: cooking incredible food and delivering an amazing guest experience. Founded by Victor Lugger and Tigrane Seydoux, the entrepreneurs and foodies behind Big Mamma, and Christine de Wendel. We are based in Paris, London, Madrid & Atlanta. We recruit food & tech enthusiasts. Our 3 values mean this: Simple - building powerful solutions through intuitive design Trust - transparent and accountable in everything we do Beyond - a collective journey, boldly driven by fearlessness
