• Manage the customer's health insurance policy, by membership, to receive customer requests for additions and / or exclusions and / or amendments to the table of the health insurance policy.
• Reviewing and checking the validity of the customer's request and its conformity with the regulations and regulations of the Cooperative Health Insurance Council, and fulfilling the necessary with the customers in the event of a lack of information provided.
• Follow up the completion of customer requests with insurance companies and the issuance of necessary attachments and adherence to the time and accuracy.
• Review the documents issued by the insurance companies on the basis of the requests of customers, and ensure their authenticity and compliance with customer requests.
• Responding to customer inquiries, in terms of regulations and regulations or in terms of the current status of their applications.
• Keep a record of all amendments made during the validity of the health insurance policy.
• Receive medical compensation claims from customers and ensure that they are met and delivered by insurance companies after review by the medical claims supervisor.
• Communicate with customers or other interested persons to obtain the missing information to complete the medical claim.
• Registration of compensation claims in the computer with follow-up implementation and work to adhere to speed and accuracy.
• Communicate with insurance companies to follow up compensation for claims in a manner that provides the interest of the client in the first place.
• Resolves complaints and answers to questions from customers regarding services and procedures related to medical claims.
• Receipt of claims compensation from insurance companies and delivery to customers.
• Save correspondence files and reports in a way that is easy to refer to.
• To carry out any tasks assigned to him by the President directly related to the nature of his work.
Requirements:
Higher Diploma or Bachelor of Business Administration or equivalent in similar specialization
