Job Description
Title: Supervisor - Claims & Customer Service
Company Name: ZK IT Solutions Ltd.
Vacancy: Not specific
Job Location: Anywhere in Bangladesh
Employment Status: Full-time
Educational Requirements:
∎ Bachelor of Business Administration (BBA)
∎ Skills Required: Exceptional customer service skills
Experience Requirements:
∎ At least 5 year(s)
∎ The applicants should have experience in the following area(s):
Call Centre Supervision/ Management, Health Insurance Claims Settlement
Job Responsibilities:
∎ Customer Service Helpdesk
∎ Handle incoming inquiries (via online chat, phone, emails, portals) from policy holders / covered members/Providers pertaining to eligibility status, benefits entitlement, benefits exclusions, providers network, status of approval for Guarantee of Payment(GOP) request and status of approval for reimbursement claims as well as any matters pertaining to the medical benefit scheme, and Final Guarantee Letters (Pre-discharge).
∎ Handle incoming inquiries (via online chat, phone, emails, portals) from Providers pertaining to.
∎ Monitor to ensure on-time receipt and service attendance of all incoming calls by Customer Service and Claims Assessors, as well as Manage roster and attendance of team members to maintain answered calls at close to 100%.
∎ Assist team members to 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 of Payment Letters from corporate HR/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(Electronic Claim & Clearing System).
∎ Reimbursement Claim Processing
∎ Receive, review and process Reimbursement of "Pay and File" claims submitted by policy holders / covered members as well as transcription of data into ECCS(Electronic Claim & Clearing System).
∎ 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.
Additional Requirements:
∎ Age at least 28 years
∎ Both males and females are allowed to apply
∎ Thorough understanding of Customer Service and Health insurance claims assessment
∎ Minimum Graduation from any reputed institution.
∎ Minimum 5 to 7 years experienced in Life Insurance or related industry/ Contact center
∎ Should be able to train Claim Assessors on Customer Service, Contact Center Norms
∎ Strong interpersonal skills, approachable and ability to influence through effective communication, confidence and sincerity.
∎ Ability to deliver on-time, plan and execute effectively, manage critical situations, adapt and deliver under stress.
∎ Fluent in written and spoken versions of both English and Bengali.
∎ Computer skills: Word, Excel, Power Point.
∎ Self-motivated, independent and customer focused with excellent problem-solving skills.
∎ Well organized, able to work independently.
Salary: Tk. 25000 - 40000 (Monthly)
Compensation & Other Benefits:
∎ T/A, Mobile bill
∎ Salary Review: Yearly
∎ Festival Bonus: 2
Job Source: Bdjobs.com Online Job Posting.
Application Deadline: 9 Dec 2023
Company Information:
∎ 9 Nov 2023
∎ ZK IT Solutions Ltd.
∎ Address : 1267 Vatara Main Road, Vatara, Dhaka-1212.
Category: Customer Support/Call Centre
: The job profile requires the challenge of handling high volume of customer/member interactions for health insurance claims and ensuring that all claims are processed within TAT (Turn Around Time). The job holder expected to have experience in handling big teams of customer service and claim assessors for health insurance.
