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Insurance Officer ? Healthcare Pharmacies

2.00 to 7.00 Years   Kuwait   13 Sep, 2023
Mohamed N. Al Hajery and Sons Co. LTD
1 Jobs Openings
Job LocationKuwait
EducationBachelor's degree / higher diploma
SalaryNot Mentioned
IndustryOther Healthcare Services
Functional AreaNot Mentioned

Job Description

Job Purpose:Responsible for ensuring the insurance operations pertaining to all Call Centre Pharmacies within Al-Hajery, in addition to monitoring productivity and standards, planning and monitoring work flow and project assignments, in line with Mohamad Al Hajery & Sons set Policies & Procedures.Policies and ProceduresImplement the Department?s policies and follow the set procedures in order to achieve the Division objectives.Activities

  • Process claims from receipt, entering details on appropriate computer and manual records systems, corresponding with claimants, their representatives, loss adjusters, contractors and managers as necessary, taking the lead in resolving problems and ensuring efficient execution in MNH best interests.
  • Ensure all high value and/or complex claims are passed referred to the Direct Report for involvement, advice, and/or authorization as required.
  • Maintain records of claims history for relevant policies and identify any significant trends (good or bad) for the attention of line management.
  • Claim creation for all Pharmacies branches from the call centre with the support of all call centre pharmacists.
  • Claim insurance auditing for all the pharmacies before submitting to insurance companies and preparing statement.
  • Receive the rejection sheets for correction and resubmit it again to the insurance companies.
  • Receive the reconciliation sheets to know the final rejections and sort it according to responsibilities for these rejections.
  • Train all the pharmacists, call centre and new joiners with different insurance online platforms.
  • Maintain a working knowledge of all relevant insurance policies, both externally and internally.
  • Ensure information for renewals and declarations of externally insured policies collected and reported within timescales.
  • Liaise with both internal departments and external professionals and keep relevant records of cover complete and up to date for new terms.
  • Ensure that any changes in external interests are dealt with promptly and reported to the Direct Report.
  • Collect information on all relevant loss and potential loss incidents and input the data to the claims handling computer system.
  • Perform other duties related to the job as assigned by the Direct Manager.

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