PURPOSE OF ROLE : The purpose of the job is to manage the inpatient medical claims cost in the assigned medical providers and develop the relationship with medical providers.
There are additional responsibilities of assisting in medical complex cases to ensure proper medical case management for the insured members and implement investigations, procurement strategic action plans and audit strategic action plans.
TASK OVERVIEW (amongst others) : You will :
Provide guidance and expert medical direction to the medical claims teams, insurance departments of the medical providers;
Investigate and audit medical record within assigned medical provider;
Represent AXA effectively both in front of providers as well as customer;
Build relations with key stakeholders in assigned medical providers;
Ensure that the medical services provided to AXA members in the designated network of providers are up to the highest medical standards;
Regularly visit to AXA members (critical medical cases) in assigned medical providers;
Be responsible of medical case management within assigned medical providers
Technical skills :
Requires a sound knowledge of all medical insurance, pricing fee / arrangements and billing policies;
Demonstrates an expert knowledge of medical conditions, treatments and procedures in order to guide claimants and challenge medical practitioners and healthcare providers;
Possesses a good knowledge of Microsoft Office such as Word, Excel, and Powerpoint .
Academic Qualifications :
Completed tertiary education in MBBS or Medicine.
With minimum 3 years work experience in Healthcare Insurance specifically in Claims, Approvals and in Network Provider relationship.
Behavioral competencies :
Strong in Customer Service Orientation
Excellent Relationship Building skill
Good Spoken and Written communication skill
About AXAWould you like to wake up every day driven and inspired by our noble mission and to work together as one global team to empower people to live a better life?
Here at AXA we strive to lead the transformation of our industry. We are looking for talented individuals who come from varied backgrounds, think differently and want to be part of this exciting transformation by challenging the status quo so we can push AXA - a leading global brand and one of the most innovative companies in our industry - onto even greater things.