Job Description
Title: Claims and Customer Service Manager
Company Name: ZK IT Solutions Ltd.
Vacancy: --
Age: at least 28 years
Location: Dhaka
Salary: Negotiable
Experience:
∎ At least 7 years
∎ The applicants should have experience in the following business area(s):IT Enabled Service, Call Center
Published: 2 Jan 2024
Education:
∎ Bachelor degree in any discipline
Requirements:
Additional Requirements:
∎ Age at least 28 years
∎ At least 7 year(s) The applicants should have experience in the following area(s):
∎ Management
∎ Customer Service Management
Responsibilities & Context:
∎ Customer Service Helpdesk
∎ Handle incoming inquiries (via online chat, phone, emails, portals) from policy holders / covered members pertaining to eligibility status, benefits entitlement, benefits exclusions, providers network, status of approval for GL request and status of approval for reimbursement claims as well as any matters pertaining to the medical benefit scheme.
∎ Handle incoming inquiries (via online chat, phone, emails, portals) from Providers pertaining to status of approval for Initial Guarantee Letters, Top Up Guarantee Letters and Final Guarantee Letters (Pre-discharge).
∎ Handle general grievances and complains from policy holders / covered members and providers.
∎ Cashless Claim Processing
∎ Receive, review and process incoming Requests for Initial and Top-up Guarantee Letters from policy holders / covered members and providers.
∎ Review and adjudicate Final bills prior to policy holders / covered members' discharge from hospitals as well as transcription of data into ECCS.
∎ Reimbursement Claim Processing
∎ Receive, review and process Re-imbursement of "Pay and File" claims submitted by policy holders / covered members as well as transcription of data into ECCS.
∎ Medical Review
∎ Assist, support and facilitate the Medical Advisor/Claims Manager in eye-balling (reviewing) the Patient-in-Bed Dash Board for the purpose of case monitoring and concurrent review.
∎ Assist, support and facilitate the Medical Advisor/Claims Manager in performing any other related duties.
∎ Review, investigate and follow-through Exceptions Listing of out-patient claims of Panel Providers
∎ Back-office Support & Management
∎ Assist, support and facilitate the setup of payor account, corporate account, health plans, user access and enrollment of policy holders / covered members.
∎ Assist, support and facilitate the setup of provider account, user access and training to provider via call.
Required Skills & Expertise:
Compensation & Other Benefits:
∎ T/A, Mobile bill
∎ Festival Bonus: 2
Workplace:
∎ Work at office
Employment Status: Full Time
Job Location: Dhaka
Company Information:
∎ ZK IT Solutions Ltd.
∎ 1267 Vatara Main Road, Vatara, Dhaka-1212.
Address::
∎ 1267 Vatara Main Road, Vatara, Dhaka-1212.
Read Before Apply: Please apply only who are fulfilling all the requirements of this job
Application Deadline: 26 Jan 2024
Category: IT/Telecommunication
