Qureos Mentor

Sukoon Insurance

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 Job Summary:
 
 
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 Efficiently lead the Contact Centre&rsquo;s team to continuously improve Customer Service &amp; Production through consistent delivery of superior customer experience.
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 Support the Contact Centre Head in ensuring adherence to Contact Center Service Standards / SOP&rsquo;s and Department Objectives.
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 Job Accountabilities:
 
 
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 Lead the call centre by developing, implementing and reviewing call centre processes for inbound and outbound operations and related responsibilities and tasks;
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 Drive customer satisfaction by ensuring timely resolution of customer queries and complaints, building relations and gaining credibility, through continuous monitoring of call centre KPIS;
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 Training &amp; Coaching: Maintaining high product knowledge level for all team members resulting is efficient call handling , sales and conversion ratio .
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 Updating team members on Process changes, new product release &amp; system changes.
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 Ensure consistency in adherence to the call centre guidelines, underwriting guidelines and operational procedures;
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 Accountable for direct sales in the consumer lines of business;
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 Ensure consistency in adherence to the call centre guidelines, underwriting guidelines and operational procedures;
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 Quality Scores : Maintaining high call quality standards through daily guidance , buddy training &amp; calls monitoring.
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 Set and measure performance targets for speed, efficiency, sales and quality;
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 Manage the daily running of the call center, including sourcing equipment, effective resource planning and implementing call center strategies and operations;
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 Set and measure performance targets for speed, efficiency, sales and quality;
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 Monitor random calls to improve quality, minimize errors and track call center agent performance;
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 Organize staffing, including shift patterns and the number of staff required to meet demand;
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 Forecast and analyze data against budget figures on a weekly and/or monthly basis;
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 Manage the complaint management function and ensure adherence to all DHA/HADD laws on complaint handling.
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 Support team development through periodic review, mentoring, counseling, and feedback.
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 Key Performance Indicators (KPIs):
 
 
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 CC abandoned rate
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 GPW production
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 Team&rsquo;s Product knowledge
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 GPW Production
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 Team&rsquo;s Quality scores
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 Service Excellency &amp; Complaint Management
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 Team&rsquo;s Data Capture &amp; Accuracy
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 MIS &amp; Reporting
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 Initiative
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 Skills Required:
 
 
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 Proven experience as call center manager or similar position.
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 Knowledge of performance evaluation and customer service metrics .
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 Solid understanding of reporting and budgeting procedures.
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 Experience in basic financial analysis (cost-effectiveness, cost-benefit etc.).
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 Proficient in MS Office and call center equipment/software programs.
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 Outstanding communication and interpersonal skills.
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 Excellent organizational and leadership skills with a problem-solving ability.
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 Positive and patient.
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 Certified Call Center Manager (e.g. CCCM) or equivalent qualification is a plus.
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 Education, Experience and Formal/Professional Qualifications:
 
 
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 Graduate of any bachelor&rsquo;s degree
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 5 years experience in Insurance / Finance industry
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 5 years experience in Call Center /Customer service team lead role
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</div>

Manager, Call Center

<div>
 
 Medical Pre-authorization Team is looking for a dedicated DRG Inpatient Pre-authorization Specialist to join us in strengthening our approvals and drive case management.
 
 
 
 
 
 Job Purpose:
 
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 The jobholder will be responsible for managing inpatient cases as per defined TAT and ensuring accuracy of DRG codes submitted by Healthcare Providers.
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 Jobholder must possess ability to deliver in a metric driven high pressure environment which functions in real time.
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 Strong attention to detail; high degree of speed and adjudication accuracy.
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 Strong proficiency in handling computer and software skills.
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 Job Responsibilities:
 
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 Visit providers to manage inpatient cases, review DRG codes/severity levels submitted by healthcare facilities.
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 Coordinate with physicians/providers efficiently&amp; Ensure effective communication with provider.
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 Negotiate cost with providers, ensure correct length of stay of inpatient cases and effective implementation of insurance protocol/DRG billing.
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 Ensure all regulatory guidelines issued by the various regulatory bodies are adhered within day to day operations.
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 Meet DRG Case Management defined targets;
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 Meet 100% of assigned onsite visits to identify medical negligence, compromised member care and wastage . 100% compliance of ePAR process and guidelines.
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 Ensure closure of case visit findings and accurate adjudication of ePAR cases.
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 Prepare analytical reports of DRG cases and billing on a monthly basis.
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 Additional Skills:
 
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 Excellent coding skills; minimum five years of coding and IR-DRG and AP DRG experience.
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 Knowledge of MS Office especially in MS-Excel.
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 Knowledge of the full know-how of UAE insurance industry and regulatory environment. Interpersonal and influencing skills. Problem solving and decision making capabilities.
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 Good command over English (Written, Spoken &amp; Reading).
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 Any Certifications in Medical Coding will be a key advantage.
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 Ability to work under pressure and multitask in a highly dynamic environment.
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 Good communication, negotiation, presentation and interpersonal skills.
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 Qualifications:
 
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 Bachelor&rsquo;s degree in medicine is mandatory.
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 Globally recognized qualification in coding skill. Insurance qualification/background is essential in similar role.
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 Minimum working experience of 1-2 years in UAE in similar role.
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 Candidate must have good exposure to IP case preapproval protocols.
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 Candidate must possess and be well versed with regulatory guidelines.
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 </ul>
</div>

Specialist,DRG Case Management

Join Sukoon Insurance and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Sukoon Insurance

About Company

Manager, Call Center

Specialist,DRG Case Management