Medical Benefits Officer

Job Purpose:
Support the Manager in customer service operations and ad hoc project work across the department to ensure adherence to company policies, standard operating procedures and regulatory authorities mandates. In all areas, maximise the use of automation to limit company expense and improve efficiency. Ensure that Medical Benefits (MB) policy and procedures are upheld in all operational activity. Administrate projects, scheme updates and process revisions in line with MB objectives and management direction ensuring accurate documentation of process and policy change in line with audit parameters. Support management reporting with reports and dashboards. 
Job Accountabilities:

• Support claims, pre-approvals and customer support teams across medical and administrative operations to ensure they are operated effectively within the MB team thereby ensuring consistency. Work with the Manager to identify and monitor quality and establish problem areas and implement corrective action.
• Maintain a consistent business process review approach making maximum use of automation to improve speed and quality of internal processes and the customer experience.
• Compile feedback from various sources thereby measuring external medical providers and healthcare benefits, documenting and investigating to seek recommendations for quality improvements.
  

Specific to Customer Support

• Provide enhanced customer support activities (direct, call and Salesforce case management) to ensure internal customers are consistently given an excellent experience through both internal support and service delivered by external network providers.
• Collate experience trends and customer feedback reports to document activity with external providers and meet network administrators to drive expected customer experience standards and initiate continuous process improvement activity.
• Maintain an enhanced understanding of all customer touchpoints to propose efficiency across systems, policy and process.
• Demonstrate advanced communication skills with the ability to work across all disciplines and business groups.
• Support the development of internal communication, create templates and online tools that enhance the employee understanding.
• Work closely with the HR Manager Member Advocacy to correspond and communicate via telephone, email or personal visits with covered members, internal stakeholders and external medical providers to discuss and resolve matters relevant to the customer experience.