Claims Manager

Job description / Role

CLAIMS MANAGER – LEBANON

Scope of Duties and Responsibilities

• Manage and develop team: monitor workload, ensure job proficiency, develop career goals by evaluating and monitoring individual staff performance and giving appropriate feedback, identify training and development needs and support training attendance
• Lead and motivate staff to achieve excellent customer service standards, retain staff and create a good working environment, recognize accomplishments, and serve as role model and coach by providing feedback to improve performance and executing progressive discipline as needed.
• Establish, communicate and manage goals and expectations for department and individual performance.
• Responsible for workload distribution and for ensuring adequate staffing/resources daily and on a long term basis (including hiring process); work collaboratively with business productivity department to schedule staff and distribute daily workload, as well as forecast future staffing resources to ensure optimal customer service.
• Monitor and audit daily performance to ensure the best possible customer service.
• Ensure contractual agreements are being met daily.
• Continuously work to identify broken processes; develop, recommend and implement improvements.
• Analyze customer volumes and provide customer service reports to management.
• Plan and facilitate effective team meetings to share important customer or product knowledge resulting in improved communication and proactive resolution to customer inquiries.
• Investigate, Negotiate and settle claims within delegated Authority.
• Regularly review outstanding claims and liaise with the Management/Finance Department to ensure the adequacy of claim reserves.
• Control and monitor the appointment of Loss Adjusters and carry out minor surveys.
• Prepare all statistics required by Management including Claim cost, Average Claim Ratio.
• Manage and supervise Team outputs as well individual performance.
• Achieve monthly team targets in terms of claims processed.
• Communicate with other department managers pertaining to issues related to claims processing and vice versa
• Develop and monitor subordinates skills to fulfill the tasks requirements and enable motivation of staff and encourage their professional growth.
• Handle internal and external communications related to the issues of department on a day to day operation in a timely and professional manner.
• Build employees to be a client oriented focus, keep them motivated with support and directions.
• Develop and maintain beneficial working relationships with subordinates and colleagues and meet inter departmental deadlines.
• Promotes the best image for the company through the professional appearance and behavior and adhere to company standards and procedures.
• Conduct staff appraisal using company performance appraisal tool & ensure unit performs its task to have the medical ethics respected at all times.
• Contribute in developing, updating and implementing policies and procedures to suit the functional objective of the business.
• Responsible in implementation of the core processes with accountability on the overall performance of the department.
• Suggest updates in policies and procedures within the department to be followed by the staff members.
• Manage process claims targets and quality check of data & efficiency of the staff members according to operational measures.
• Ensuring high level of quality in daily claims processing for maximum medical data collection.
• Ensure employees follow company ethics/values at all times.
• Control over daily work load by maintaining records of the individual Processor and giving them feedback on one on one session.
• Maintain the productivity reports of the team members.
• Preparing & Maintaining Weekly & Monthly Process Report.
• Suggest training requirements of staff to ensure productivity and growth
• Apply and respect Company’s leadership principles and create an environment of open communication and continuous improvement.

Requirements

Lebanese preferred, but not essential

Bachelors of Medicine

Experience in the industry for at least 5-8 years.

Good English communication skills.

Salary range: Negotiable.

About the Company

At Horizon International we pride ourselves on delivering quality results whilst working to the highest professional and ethical standards.

We are a market leader within recruitment with extensive market knowledge and global recruitment experience. We deliver through a network that regularly takes us to the four corners of the world, negating the need to rely on the local market.

Our personalised approach ensures that our candidates are fully supported throughout the recruitment process. Whilst providing our client’s with innovative human capital solutions, enabling them to meet their strategic staffing needs.