Job closed
Ref: HP704-424
Job description / Role
- Deliver an accredited Quality Management System (QMS).
- Ensure that the processes needed for the QMS are established, implemented and maintained in claim department and network department.
- Recruitment and management of a Quality Systems team required to deliver and manage an accredited QMS.
- Liaise with the external assessment body on all matters related to the accreditation process or other audit requirements.
- Ensure the QMS is operating effectively and report to the General Manager and the business on the performance of the QMS.
- Develop robust plans that mitigate internal and external compliance risks, identify improvement opportunities.
- Lead and deliver significant improvement projects.
- Development of a robust Document Management System as part of the QMS solution.
- Reviews the accuracy of case processing activities ( Claim Processing, Claim Payment, Approval Checking, Financial accuracy, , claim accuracy, Premium Collocation) , and data entry to ensure compliance and consistency with administrative procedures and guidelines
- Verified and ensure about Time-to-Process of claim.
- Ensure about payment accuracy 99.3% of the total claim paid.
- Ensure about payment accuracy 97% of on the condition that the correct payment details are provided by the claimant.
- Check preformed on a weekly basis with immediately feedback to staff and Report weekly results to the management.
- Provide Training requirement to manage and control error in each department
- Coordinate with line manager of each department and support them to decrease risk in each function in the department
- Develop weekly and monthly reports to management.
Requirements
- Bsc Degree & Quality Audit
- CIA certificate internal auditor / Quality Auditors Certification
- Good Knowledge of Insurance / TPA / and Reinsurance Company / claim / premium / medical insurance.
- Lead auditor and ability to conduct major process failure investigations and lead multi-functional improvement activities.
- Attention to detail and the determination on quality standards are essential.
- Ability to communicate effectively with key stakeholders at all levels within an organization.
- Ability to lead, manage and motivate a team to deliver and improve.
- Good literacy & numeracy skills.
- Member of the Chartered Quality Institute and Chartered Quality Professional.
- 3 or more years of claims auditing experience and more than 5 years claims adjudication experience.
About the Company
Established in 1996, Clarendon Parker Bahrain is an International Recruitment Specialist Consultancy based in Bahrains Seef Business District. We specialise in mid to senior level professional, managerial, technical recruitment and staffing solutions in Bahrain and beyond. Our multinational team of consultants are experienced professionals within the fields they represent. Each consultant brings strong industry links and knowledge to better understand your business requirements. We know the market and we know our candidates!
Our team of dedicated consultants specialise in the following industries:
Accounting, Finance & Banking Logistics & Customer Service Secretarial & Administration Human Resources & Recruitment Engineering & Construction IT/Telecom Marketing & PR Oil and Gas
The current range of services includes permanent and temporary recruitment, recruitment advertising campaigns, employee satisfaction surveys, state-of-the-art web-based recruitment technology and HR consulting services relating to recruitment processes and activities.