For MedNet Jordan Co. W.L.L.
MedNet Jordan is one of the leading managed care service organizations that caters to healthcare needs. We are currently seeking to hire an Assistant Manager - Claims (on Hybrid working modules basis) with the following tasks and responsibilities:
Your Job
·Manage and control overall claims processing operations for provider and insured member direct claims in compliance with company policies & procedures and work instructions
·Perform workforce management ensuring right staffing to provide services according to external SLAs and internal KPIs
·Monitor process and system performance from business user perspective and liaise with IT Department for changes/modifications/new reports that lead to improved performance, ensuring adherence to automation requirements as per local regulatory standards.
·Act as contact point for key PICs to ensure claims services are provided as per Service Level Agreements.
·Motivate staff and identify opportunities for continuous improvement of claims processes, systems, leveraging international leading practices, leading to productivity and quality gains.
·Maintain close rapport with major clients; visit/meet clients; discuss claims, claims procedures or other matters and adopt the best way forward for resolution of such matters.
·Act as focal contact person to insurance providers, insurance companies to ensure effective troubleshooting in the event of any issues regarding claims.
·Prepare and recommend to the direct line manager the claims department budget and monitor financial performance versus the budget
·Manage the effective achievement of objectives through setting individual objectives, managing performance, developing staff and providing formal and informal feedback to maximize overall performance and team motivation.
·Recommend improvements to departmental policy and manage the implementation of procedures and controls covering all areas of data entry and claims processing activity so that all relevant procedural requirements are fulfilled while delivering a quality, cost-effective service.
·Ensure compliance to all relevant quality, health, safety and environmental management procedures and controls across the department to guarantee employee safety, compliance, delivery of high-quality products/ service and a responsible environmental attitude.
·Supervise the preparation of claims processing reports in a timely and accurate manner to meet MedNet policies and standards, and department requirements.
Your Profile
·Bachelor’s degree in nursing science, Pharmacy, Dentistry, Paramedic certificate or any related field.
·8 years’ experience of medicine practice of which is at least 4 years in TPA / medical insurance sector as well as 2 years of Supervisory Experience.
·Knowledge of concepts of medical insurance.
·Attention to details
·Ability to operate effectively with people at all levels of the business.
·Negotiation skills