Job Purpose:
What does the job do for the Company
- Review, accreditation, and quality control of medical service providers
- Supports NBU in gathering information for medical analysis in order to determine eligibility for insurance
What end result does it produce
- Accurate, consistent, and timely results and customer service rendered by accredited medical service providers
- Improved turn-around time in processing medical cases for new business, after-sales, and claims
- Readily available medical examiner for clients who are required to undergo Full Medical Exam (FME)
How would success for this position be described
- Attained SLAs and standards for the network of accredited medical examiners
- No risk and compliance issues arising from the network of accredited medical examiners
- Good claims experience as complete details of current medical condition and medical history of client will be provided to NBU
- Customer satisfaction
Job Accountabilities
- Manage the review and accreditation of qualified medical service providers nationwide (e.g., clinics, examiners, laboratories) to support the medical risk assessment of submitted new business and applicable after-sales cases.
- Conduct regular performance reviews of accredited medical service providers to ensure the attainment of service level agreements and ensure the quality of examination results.
- Monitor and validate related fees and charges paid out to the network of accredited medical service providers.
- Develop and implement process improvement and quality control initiatives to ensure the consistency, accuracy, and high quality of customer service and examination results provided by accredited medical service providers.
- Perform Full Medical Examinations (FME) for prospective customers through a comprehensive interview and medical assessment of the proposed insured and policy owner, if applicable, based on guidelines and processes set by the Head of NBU.
- Provide timely and accurate assessments of new business, after-sales, and claims medical cases.
- Perform all medical-related activities for employees (i.e., consultation on simple medical cases and emergency-related conditions) in close coordination with the company nurse and HRD.
- Ensure that all compliance matters are identified and openly and honestly reported to the Line Manager and Compliance Officer in accordance with the reporting requirements operated within the work unit and the Company.
- Ensure adherence of the work unit to compliance and risk management standards. This includes installing a risk culture within the team and completing risk-related requirements.
