As a member of the operations team, you will administer general health insurance and group life policies while assisting clients with reporting and managing ongoing services.
Your daily interactions with the operations team, consultants, insurers, and clients will involve communication.
Clients’ Role for the Specialist in Health and Benefits Operations in Jordan
• To make sure effective claim submission, review, and resolution of any problems with pre-approvals or claim reimbursement.
• Compiling and examining any missing data, and create routine claim status reports.
• React to and support client/consultant inquiries about claims, coverage, and eligibility.
• Gather, examine, and keep track of rejections and settlements.
• When necessary, join the consultant’s and/or the business development team during client meetings.
• Serves as a point of contact for clients and carriers, handling service concerns and keeping an eye out for trends.
• Ensure that operations transactional procedures (such as Client Onboarding, Medical Cards, Billing Premium, Commissions & Fees, and Census Management) are implemented correctly.
• Implementing claims management procedures efficiently (Claims data provisioning from relevant providers, handling and settlement of claims, Pre-approval monitoring and escalation, Negotiate claims settlements with Insurers with a team of Claims specialists).
• Ensure that all data is routinely updated on BE and other IT platforms.
• Identify places where the claims processing can be made more efficient.
• Find areas where administrative procedures might be made more efficient.
• Ensure that the cost control goals for claims servicing are successfully carried out.
• Adhere to the Excellence Model from H&B.
• For managing data-related procedures, consistently use the Benefits Engine Data Management module.
• Promotes high-quality client deliverables, making sure they are vetted by others and adhere to business standards.
Requirements for the Specialist in Health and Benefits Operations in Jordan
- Working knowledge of Excel, MS Project, and MS Word are must.
- Experience working in the insurance industry is also essential.
- Strong analytical and creative skills; working knowledge of Excel, MS Project, and MS Word
- strong interpersonal and team skills
- polished and well-developed oral and written communication skills
- self-starter attitude and ability to work with ambiguity.
- flexibility and proven ability to diagnose and resolve issues.
Procedure for Applying
Stages 1: online application
Stage 2: recruiter evaluation, pre-recorded video (technical assessment)
Stage 3: live video interviews with hiring managers
Stage 4: offer, and onboarding.
WTW is an employer that values diversity.