Job Description Summary
PRUShield Claims recovery is a key initiative for the Medical Portfolio Management team. It is the process of assisting customers in submitting claims to a third-party insurer. This role includes reaching out to customers via 2-way sms, follow up calls with customers and to follow through with the collation of medical receipts and report on behalf of the customer. The medical documentation is submitted to customer’s HR department and the team will complete the process by following through with the group insurers.
The primary objective of this role is to assist customers and financial consultants with the recovery process. In addition, the specialist must create awareness of the benefits of submitting a recovery claim.
This is an exciting opportunity for those keen on taking on a new challenge that will have a direct positive impact to our organisation’s bottom-line.
Job Description
Objectives for Medical Services Specialist
- Reporting to Medical Services Consultant, you will conduct daily outbound calls to customers and promote the benefits of a recovery claim.
- Achieve performance targets set, which include daily call productivity, contact rate, and success rate.
- Provide assistance to walk-in customers which will be based at our concierge offices/ counters located offsite in our private partner hospitals on PRUShield claims related enquiries including advice on third party recovery and its benefits.
- Collect the patient consent forms of customers who have been admitted to our partner hospitals.
- Reach out to customers who have given their consented to be contacted to offer assistance with claims and also issue transportation vouchers who qualify.
Role & Responsibilities
- Ensure SOP are followed when handling outbound and inbound calls to customers at all times.
- Daily reporting to Medical Services Consultant on call activity and outcomes. Provide end to end support for each case handled.
- Ability to assist customers on their recovery claims process.
- Reply to emails related to claims recovery and concierge services and answer hotline calls.
- Attend service and product trainings or any other trainings as and where required.
- Adhere to standard operating procedures for customer data privacy and protection.
- Provide Team Lead with feedback from customers and financial consultants.
- Adhere to company’s code of conduct.
- Provide on-site concierge services at private panel hospital
- Achieve PRUShield Recovery performance targets set; which include daily call productivity, contact rate, and success rate.
KPIs
You will be required to:
- Make 20-30 outbound calls daily
- Meet the set target for submission of claims to third party insurers
- Meet the set target for recovery payments received from third party insurers
- Attend to calls and emails pertaining to third party recovery and concierge matters within the agreed TATs
Qualifications / Criteria
- Friendly, proactive and service oriented individual.
- Team player and enjoys being in a target driven team.
- Two years’ experience with outbound or in-bound call centre environment.
- One to two years’ experience in integrated shield or life insurance preferred.
- Poly diploma, GCE A level or relevant work experience.
- Life insurance qualifications – Certificate in Life & Health Insurance.
