JOB OPENINGS

1. Senior Officer – Retention (Individual Medical)

Roles & Responsibilities:

  • Product Management of Individual Medical and ensure that the competitive medical products are offered in the market with UAE market requirements.
  • Coordinate with marketing/distribution channels/Direct Customers to address any potential service issues.
  • Coordinate with Brokers/Direct Customers and follow up on retention and ensure that the retention levels are maintained at always agreed percentages.
  • Coordinate with Customer Services team to get the regular feedback on service issues and customer satisfaction.
  • Coordinate with IT team for any issues related to IT Portal (B2C or B2B).
  • Update the Management on any issues with regards to Individual Medical products.
  • Produce Management reports on a regular basis on retention, loss ratios and production and any other reports on time to basis.

Qualifications and Education Requirements:

  • Bachelor’s Degree in related courses.
  • Working knowledge Medical insurance products, procedures and regulatory requirements.
  • Relevant experience of 3 – 5 yrs. in retaining individual medical customers via broker channel in UAE.

Skills & Competencies:

  • Computer literate with superior skills in Microsoft Word, Excel and PowerPoint.
  • Strong oral and verbal communication skills.
  • Strong analytical skills (Analyzing data and creating reports for the management).
  • Sound interpersonal skills at all organizational levels with the ability to establish rapport with personnel across a wide variety of areas.
  • Target oriented with an ability to work under minimal supervision.

2. Senior Officer – Medical Audit

Job Purpose:

To be responsible for performing providers Audit Campaign, and identifying unfavorable trends in providers billing, maximize audit findings and recovery through providing solid audit ground.

Responsibilities:

  • Assists the Line Manager in implementing and managing claims denial, approvals communication and management with TPA, health care provider, insured member and health care regulators (Dubai Health Authority/ Health Authority of Abu Dhabi). Conducts medical audit for fraud, waste or abuse with health care providers.
  • Assists in the review of claims which are suspected for abuse and medical claims audit with TPA.
  • Responds for home country members approval and claim coordination with TPA.
  • Implements knowledge of HAAD/ DHA regulations without TPA on claims management.
  • Performs audit of TPA performance.

Minimum Requirements:

  • Completed MBBS / MBChB/ Equivalent Degree.
  • Proficient knowledge of HAAD & DHA.
  • Working knowledge of general practices for medical insurance procedures.
  • At least 1 – 3 years’ experience in a similar role in Healthcare Audit with coding experience in the UAE Insurance Industry.
  • Freshers with MBBS / MBChB/ Equivalent Degree may also apply.
  • Good communication skills in Arabic both written & oral.
  • Candidates having work experience as Medical Doctors in Government Hospitals in the UAE (Preferable).
  • Coding certification; CPC & IPDRG (Preferable).

3. Senior Officer – Medical Underwriting

Roles & Responsibilities:

  • Analyzes and reviews quotations (new cases & renewals) as requested by the Sales Department for clients/brokers.
  • Receives quotation templates and ensures all information provided is accurate and complete.
  • Verifies all relevant client information provided by the sales staff/clients/brokers, e.g. General Company Data, Claims Loss Ratio etc. in order to use for risk assessment.
  • Based on the quotation template and data provided by the sales team/clients/brokers, assesses the level of risk and adjusts the rates accordingly and forwards to Operations for further processing.
  • Approves/ denies the quotation generated by U/W team based on risk assessment according to authority levels and refer where required to the U/W Manager.
  • Analyzes current year claims utilization in order to prepare renewals terms for all relevant clients.
  • Assists Underwriting Manager with preparing quotes for various tailor-made products for clients that may require policy schemes and plans that are not a part of the Company’s standard insurance plan.
  • Responds to general queries about pricing from the Brokers/Sales Department, providing them with all necessary information for the client.
  • Participates in performing renewal calculations/ assessment on monthly basis for cases due for renewal within the approved authority and refer cases above the authority to immediate manager.
  • Assists in preparing monthly and quarterly Claim/ Loss ratio reports for the Senior Management.
  • Assists Underwriting Manager in management of day-to-day work by involving in work allocation, priority setting, review and update of procedures, involvement along with Manager in trainings and presentations.
  • Updates the U/W manager on the work volumes, pending, review of SLA, discussion and involvement with system projects and any other projects that can help simplify work and improve the service.
  • Coordinates with reinsurers in line with treaty guidelines.
  • Prepares quotes in line with market trends and working in line with regulatory (DHA/IA/HAAD) guidelines.
  • Carries out any such other task as requested by the Department Manager.

Qualifications and Education Requirements:

  • Bachelor’s Degree in related courses.
  • Working knowledge of general practices for Medical insurance procedures.

Skills & Competencies:

  • Computer literate with superior skills in Microsoft Word, Excel and PowerPoint.
  • Strong oral and verbal communication skills.
  • Sound interpersonal skills at all organizational levels with the ability to establish rapport with personnel across a wide variety of areas.
  • Goal oriented with an ability to work under minimal supervision.
  • Superior attention to detail with the ability to take ownership of issues / projects and see them through to resolution, implementation and completion with minimal supervision.

Experience:

  • Minimum 4 to 6 years of relevant experience in Medical Underwriting in UAE.

APPLY NOW

Send your updated CV to careers@takafulemarat.com

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