Hospital Delegate Officer

4 days ago


Al Khafji, Saudi Arabia التعاونية للتأمين Full time
About the Role

Tawuniya, one of the top insurance companies in the Middle East, is seeking a highly skilled Hospital Delegate Officer to join its team. With over 13 billion SAR in revenue and 2,000 employees, we provide a comprehensive suite of insurance products and services.

Key Responsibilities
  1. Customer Inquiry Management: Receive and handle customer inquiries related to Tawuniya's insurance policies, ensuring timely resolution of any complaints that may arise to facilitate customer retention.
  2. Research and Benchmarking: Conduct research and benchmarks on the latest service desk trends to align with best practices.
  3. Patient Information Management: Manage hospital booths, collect identification and information related to patients, and develop and maintain a filing system for patient information in line with customer services guidelines and templates.
  4. Policy Verification and Guidance: Verify patients' health insurance policy and provide guidance throughout the process, including admissions, medical and lab requirements, radiology, claims, etc.
  5. Policy Coverage and Out-of-Pocket Costs: Inform patients on what their insurance policy covers and what out-of-pocket costs might be incurred.
  6. Knowledge Management: Maintain knowledge of all details related to health insurance protocols, claims, exclusions, inclusions, etc., and answer all queries.
  7. Complaint Assessment and Documentation: Assess and document customer complaints to identify corrective actions and prevent further escalations.
  8. Office Environment and Personal Appearance: Maintain a clean office environment, waiting rooms, and appropriate personal appearances.
  9. Feedback and Improvement Opportunities: Gather feedback and concerns from other hospital staff to identify improvement opportunities.
Policies, Procedures, and Processes
  1. Continuous Improvement: Contribute to the identification of opportunities for continuous improvement to enhance productivity, attain high-quality outputs, and cost-effective results in line with relevant regulatory requirements.
  2. Compliance and Escalation: Conduct day-to-day activities ensuring compliance with stipulated policies, procedures, and processes, and escalate identified non-compliance cases.
Stakeholders

Internal stakeholders: Product Management, Underwriting, Strategic Partnership Office, CEX and Marketing, Finance, Risk, Legal.

External stakeholders: Partners and Vendors.

Requirements

A bachelor's degree in business administration, Healthcare Management, or equivalent is required.


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