Job Description:
Provider Services Consultant
Cairo, Egypt
A full time role
Hybrid home and office working options available once signed off - This is not a fully remote working position.
Apply by 1st October 2024
Here you’ll be welcomed. We champion diversity and we understand the importance of our people representing the communities and customers we serve. You’ll find an inclusive environment where you can be yourself and where everyone is driven by the same purpose – helping people live longer, healthier, happier lives and making a better world.
Bupa Global is the international health insurance division of Bupa. We provide customers who want premium international coverage with products and services to access the healthcare they need anytime, around the world, whether at home or when studying, living, travelling or working abroad.
Bupa Global has offices around the world including London and Brighton (UK), Dublin (Europe), Miami (USA), Dubai (UAE, in partnership with OIC), Egypt and Hong Kong (China) as well as regional offices in mainland China, Singapore, the Dominican Republic, Bolivia, Panama, Guatemala and Ecuador
Role Overview
As Provider Services Consultant you will provide excellent customer service for our providers as stated in our aims and mission statement. You will need to make customer/provider focused actions based on effective decision-making skills. This will also include excellent internal customer/provider service, with continuous contribution given towards achieving individual, team and department goals and objectives.
What you will do
Respond to all relevant incoming correspondence and queries from our internal departments relevant to providers claims.
Re-assess and rectify simple provider paid claims into the computer system with a high degree of accuracy.
Action any claim related query in line with Bupa Global policy and style.
Obtain all necessary information on claims for the purpose of complete processing, including liaison with internal departments, using the following methods: telephone or e-mail.
Ensure the correct interpretation of Bupa Global policy and rules, using the correct compatible combinations of codes for accurate processing of data, in accordance with our service standards and customer expectations.
Contribute to the continuous development of the claims process by identifying opportunities for product development and process improvement.
Suspend claims that require further investigation in order to resolve appropriately to ensure the correct continuation of processing within agreed timeframes and standards in suspend process.
Logging claims on the system under correct members’ registrations, when needed.
Comply with and abide by the requirements of the FCA, Egyptian Financial Supervisory Authority or any other relevant regulator at all times.
Work on shift basis according to business need.
Use agreed levels of authority and previous experience to make effective business decisions.
Take ownership of the enquiries and liaise between departments to provide a ‘seamless service’ to providers.
Support new team members throughout their learning curves.
Liaise closely with the Healthcare Management Team who own/manage the contracts with providers to ensure relevant provider behaviour concerns or general feedback is given to help improve overall provider relationships between all parties
What you will bring
A medical degree/background such as Pharmacy or Dentistry
Background in the global health insurance market, or relevant transferable skills and knowledge from other financial services industries such as Life Insurance, Retail, Commercial or Investment Banking and Wealth Management
Previous experience of a complex and multi skilled customer/provider facing or claims roles are highly desirable.
A track record of achieving and exceeding productivity and quality targets
Highly customer focussed
Excellent interpersonal, communication and influencing skills are required with emphasis on achieving results and successful outcomes.
An ability to speak a second language would be an advantage
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اطلب مساعدة الخبراء لكتابة سيرة ذاتية مميزة.