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Team Leader - Medical Care Unit

Allied World Assurance Company Holdings, Ltd Dubai, United Arab Emirates
Posted 11 days ago Permanent Competitive
Team Leader - Medical Care Unit
Team Leader - Medical Care Unit

As a member of Munich Re the MedNet Group is a leading Third-Party Administrator across the MEA region. We are currently seeking to hire a " Team Leader " for our Medical Care Unit. This position holder is responsible for supervising the client dedicated Medical, Cash Claims, FWA and Customer Service teams and monitoring the performance. The Team Leader acts as the main point of contact for the client Team and for all internal stakeholders, and the responsible person to drive routine operations of the client dedicated unit in an efficient manner.

Your Role:
  • Manage the day-to-day functions of the dedicated Client Unit and implement existing Policies and Procedures in an effective manner.
  • Manage team roster and assign shifts for Authorizations, Cash Claims processing and Customer Service based on business demands.
  • Identify training requirements amongst team members and provide feedback to the department's management.
  • Supervise the team on quality assurance perspectives and provide required guidance and support.
  • Under the guidance of the Medical Manager, assign shifts and jobs based on anticipated volumes and business demands ensuring the outlined objectives of the team and SLAs are met.
  • Monitor and review Authorizations, Cash Claims , FWA activities and Customer Service in order to ensure that objectives are met in a timely and efficient manner and in adherence to procedural and contractual requirements.
  • Counter sign and review authorizations and Cash Claims in line with the laid authority matrix and provide regular feedback to the team on both medical and policy decisions.
  • Review pending cases on a regular basis and ensure SLAs are fully met and in line with authorization & Cash Claims Processing TATs.
  • Handle complex medical , cash claims , FWA and customer service issues.
  • Provide continuous coaching and feedback to the team on effective medical judgement.
  • Identify fraud & abuse trends, investigate authenticity of any escalated fraud cases from the team and approve/deny the medical case.
  • Prepare quarterly/annual KPI reports.

Your profile:
  • Bachelor's degree in medical Stream
  • Minimum of 3-4years experience in a TPA or insurance company in the healthcare industry in the UAE.
  • Should have a track record of having managed a team.
  • Experience in preauthorization and Customer service Units
  • Computer literacy (MS Office, Excel, PowerPoint)
  • Industry knowledge related to local healthcare services system.
  • Good interpersonal and negotiation skills
  • Excellent written and verbal communication skills in both English and Arabic.
  • Analytical and problem-solving skills
  • Strong Customer Service Skills
  • Excellent leadership and team management skills
  • Ability to work under pressure and strict guidelines.
  • Highly motivated
  • Open-minded
  • Innovative and Flexible

Qualifications

Minimum Qualifications:
  • Bachelor's degree in medical Stream
Minimum Experience:
  • Minimum of 3-4years experience in a TPA or insurance company in the healthcare industry in the UAE.
  • Should have a track record of having managed a team.
*Munich Re not only stands for fairness with regard to its clients; it is also an equal opportunity employer.
Job ID  24000007
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