Officer, IPMI Operations ( Nursing qualification)

Role Purpose

To manage all aspects of administration and servicing of AXA Daman customers, including provision of approvals, processing of claims, placing overseas Guarantees of Payment (GOPs), and supporting customers with enquiries on their policies via calls and emails.

Key Responsibilities

• Customer Support & Claims Handling
• Handle customer-facing tasks such as emails, calls, and overseas GOP placements.
• Manage escalations (e.g., delayed or declined pre-approvals, PBM, and reimbursement claims) and resolve during the first contact where possible.
• Cross-train on multiple tasks (RI claims, approvals, PBM override, membership tasks) to ensure quick resolution and first contact resolution.
• Offer value-added services such as Virtual Doctor and Mind Health.
• Ensure Stella feedback (global customer feedback tool) is shared after each customer interaction.

Operational & Internal Support

• Support Daman Operations team with queries on policy, pre-approval, and claims adjudication.
• Communicate with insured members and brokers on claims and requests, escalating to Daman team when necessary.
• Liaise with internal departments to ensure smooth scheme operations.
• Maintain confidentiality of all medical information.
• Perform ad-hoc tasks assigned by the manager.

Knowledge & Business Understanding

• Strong knowledge of medical policy wordings, insurance and billing policies.
• In-depth understanding of medical conditions, treatments, and procedures to support claims guidance and provider discussions.
• Knowledge of medical insurance platform structures and interaction between Daman and AGH.
• Awareness of competitors and their product offerings.
• Proficiency in IT systems (Word, Excel, data entry, reporting, data extraction, statistical analysis).

Decision-Making & Judgment

• Exercise sound judgment to ensure one-call resolution for customer queries
• Manage and prioritize multiple functional tasks within agreed turnaround times (TAT).
• Build and maintain positive working relationships between Daman and AXA.

Minimum Requirements

• Tertiary education in Clinical or Paramedical field (degree required).
• Minimum 2 years in a clinical/paramedical field.
• Preferably with customer-facing experience.
• Strong interpersonal and communication skills.
• Effective planning, organization, and time management.
• Customer-focused with the ability to motivate others.
• Positive and adaptable to different cultures.
• Operational management.
• Customer centricity.
• Coaching and motivational skills.
• Strong analytical and problem-solving ability.
• Workload management and prioritization.