Overview
Job Title : Senior Processor Executive / Team Lead (Insurance - Provider Relations) - Cantonese
Location : Malaysia
Language Requirement : Must have proficiency in Cantonese (Verbal and written)
Summary
Senior Processor Executive : Handle enquiries from network providers including but not limited to card acceptance / PA / outstanding claim status / contractual & fee review. Provide administrative support including but not limited to report generation / system updates & maintenance / claim status checking / calls to network providers as ad hoc request / maintenance of network summaries / voucher request handling. Provide administrative support including but not limited to report generation / system updates & maintenance / follow-up with network providers via email / communication with Claims for processing.
Responsibilities and Expectations
- Handle phone call and email enquiries from our network provider regarding the medical cards, pre-authorization, referrals
- Handle enquiries related to contract renewal, fee review, portal access and movement notice
- Provide information on pre-authorization status, Guarantee of Payment Letter and claims
- Update and maintain accurate records of all inquiries and provider list
- Generate different reports and network summaries on regular and ad hoc basis
- Handle movement notices and update internal systems
- Create and maintain provider records, provider related codes and contract details in internal systems
- Support onboarding of new providers
- Send notification email to internal parties on "Large Hospital Claim" cases
- Handle contract renewals and maintain system reference data
- Check claims status upon receiving enquiries from network providers
- Ensure all data entries and system updates are accurate and completed on time
- Make calls to network providers upon ad hoc request
- Team Lead : Oversee and supervise subordinates on day-to-day activities. Manage the Team to perform the duties accurately and efficiently
- Team Lead : Monitor performance of the team to ensure delivery of agreed KPI
- Team Lead : Provide regular training to staff and new joiners
- Team Lead : Maintain standard operating procedures in the team up-to-date and ensure the team’s compliance to the agreed processes
- Team Lead : Conduct regular communications and provide coordination with Team on the services. Establish internal escalation workflow
- Team Lead : Make clear and justifiable decisions and escalate to HK Team when (and only when) necessary
- Team Lead : Prepare performance reporting for review on regular basis. Handle ad hoc tasks assigned by Team
Required Experience and Skills
Desired Experience : With 1 year of experience in provider relations or health insuranceGood communication and negotiation skills. Good analytical and problem solving skillsDetail-minded and willing to accept new challengesTeam Lead Requirements : With at least 4 years of solid experience at Team lead level in provider relations or health insuranceStrong sense of continuous improvement and desire to deliver quality outputs; strive to over-deliver on SLAs to improve and enhance work efficiency and qualityExceptional communication and negotiation skillsStrong analytical, problem solving and root cause identification skills and strong attention to detailAbout Cognizant
Cognizant (Nasdaq : CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we\'re improving everyday life. See how at or @cognizant.
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