Precertification Administrator
Détails de l'annonce
Référence
125462
Date de publication
6 novembre 2020
Type de contrat
CDILieu de travail
La Goulette, Tunis, Tunisie
Expérience requise
Entre 1 et 2 ans
Niveau d'études
Doctorat
Salaire proposé
Disponibilité
Plein temps
Langues
Arabe Français Anglais
Mobilité
Internationale
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Entreprise
MSH INTERNATIONAL
Secteur: banque / finance / assurances
Taille: Entre 20 et 100 employés
MSH INTERNATIONAL is a leading worldwide provider of Healthcare insurance solutions with offices located in strategic places around the world including Calgary, Paris, Shanghai and Dubai. We are a subsidiary of SIACI SAINT HONORE.
SIACI SAINT HONORE is one of the European leading providers of brokerage and consulting services in the insurance market. SIACI SAINT HONORE designs and develops customized solutions for its corporate clients.
We are focused on providing high quality services that meet the needs of our large and diverse global client base. We recognize the importance of our human resources to achieve these goals.Description de l'annonce
Responsibilities:
1. Processing precertification requests for the assigned portfolio
2. Coordinating between administrators for approvals according to policy terms and conditions.
3. Handling pre-approval from Healthcare providers and clients.
4. Referring insured members to a second opinion when required.
5. Managing requests according to authority limits and report suspected fraud cases to supervisors.
7. Replying the insured members inquiries about procedures to be followed or status of their pre-certification file via telephone, fax, e-mail or intraqual workflow.
8. Ensuring the best customer service to providers, insured, coordinators, brokers by providing 24 hours helpline.
9. Reporting any complaint encountered to precertification supervisor or manager
Requirements:
1- Experience in the medical field is a must.
2- Previous experience in the insurance industry is preferred but not compulsory.
3- Bachelor Degree of any Medical specialty preferably dentist.
4- Flexibility to work at night shifts, during weekends and public holidays.