Claims Advisor

Marsh

Dubai

AED 120,000 - 200,000

Job description

Receive client enquiries (General/ policy related) via email/ calls and provide clients with necessary support on their enquiries. Exceptional services (quicker TATs) provided to VIP members of the group.
Receive client complaints on delays in approvals for the medicines and treatment procedures, and coordinate with the Insurer to assist members by expediting the approval of treatments.
Circulate monthly network updates and general circulars related to changes in the network.
Review, understand, and assess pre-approval assistance required by clients, inform all relevant parties of any potential problems or contentious claims, and seek guidance or advice where necessary or refer to Claims Advisors/ Advocates to ensure the proper pre-approval of cases.
Guide members on claims procedures to be followed for direct as well as reimbursement claims.
Guide members on the claims process for home country or outside UAE treatment procedures and facilitate the approvals if mandatory as per the policy of the insured member.
Provide portal submission assistance and resolve portal issues.
Promptly escalate moderate/complex pre-approval cases to Claims Managers/ Senior Management to ensure effective outcomes as per client expectations.
Receive member calls and emails related to support required from a colleague who is out of the office, understand and redirect the enquiry to the concerned colleague responsible for handling the client in the absence of one colleague.
Manage all urgent escalations outside office hours in a timely manner and as per the services agreed to meet the expectations of the top clients.