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人力资源专员 · 招商信诺健康管理有限责任公司

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职位介绍: Location: Shanghai Job Responsibilities: 1. Respond accurately within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first call resolution where possible. 2. Adjudicate claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals. 3. Monitor turnaround times to ensure claims are settled within required time scales, highlighting when this is not achievable. 4. Monitor and highlight high cost claims and ensure relevant parties are aware. 5. Provide payment guarantees as required to clients and providers. 6. Interface effectively with internal and external customers to resolve customer issues. 7. Work closely with Sales and Account Management team to provide and develop service for clients. 8. Identify potential process improvements and make recommendations to appropriate management staff. 9. Actively support all team members and provide resource to enable all operational goals to be achieved 10. Performance metrics will increase over time with proficiency and complexity of work. Initial productivity will require accurate response or completion of 15-20 items per hour, to include a mix of calls/ claims / faxes / emails) 11. Meet or exceed Service level agreement requirements. Minimally set at a 10 day turnaround for claims or in accordance with client specific requirements. This number will be reviewed periodically and can be increased or decreased based on business need. 12. Quality standards for both call and claim will be developed, communicated and meeting them will be part of the production requirement. 13. Financial accuracy of 99% for coding and payment of claims Qualifications: 1. University education required 2. 2 – 3 years experience in medical administration, claims environment or customer service focused organization 3. Fluent in both spoken and written English and Mandarin 4. Preferable insurance background 5. Strong interpersonal skills with good verbal and written communication to internal and external client 6. PC literate; Solid knowledge of basic Microsoft applications to include Word, Excel and MS Outlook. Powerpoint is desirable but not required 7. Team work 8. Strong customer focus with ability to identify and solve problems 9. Ability to work under own initiative and proactive in recommending and implementing process improvements 10. Ability to organize, priorities and manage workflow to meet individual and team requirements.

其他信息: 所属部门：健康管理公司

公司简介

招商信诺健康管理我们通过美国信诺强大的全球健康网络，在境外健康领域拥有良好的运作基础，引入境外优秀医疗资源，建立以私属医疗管家为核心的健康服务体系，基于日常就医、重大疾病、疾病预防、康复管理四大医疗健康需求场景，为客户提供一站式全流程健康服务，实现全生命周期的管理方案。我们拥有专业注册护士和资深医生团队组合的服务团队、专业的全球医疗服务经验、和来自全国40多家医院，覆盖33个科室类别，100多位资深主任级别专业医生组成的强大专家委员会。

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