南京招聘

Location: Shanghai

Job Responsibilities:

1. Respond accurately within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first call resolution where possible.

2. Adjudicate claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals.

3. Monitor turnaround times to ensure claims are settled within required time scales, highlighting when this is not achievable.

4. Monitor and highlight high cost claims and ensure relevant parties are aware.

5. Provide payment guarantees as required to clients and providers.

6. Interface effectively with internal and external customers to resolve customer issues.

7. Work closely with Sales and Account Management team to provide and develop service for clients.

8. Identify potential process improvements and make recommendations to appropriate management staff.

9. Actively support all team members and provide resource to enable all operational goals to be achieved

10. Performance metrics will increase over time with proficiency and complexity of work. Initial productivity will require accurate response or completion of 15-20 items per hour, to include a mix of calls/ claims / faxes / emails)

11. Meet or exceed Service level agreement requirements. Minimally set at a 10 day turnaround for claims or in accordance with client specific requirements. This number will be reviewed periodically and can be increased or decreased based on business need.

12. Quality standards for both call and claim will be developed, communicated and meeting them will be part of the production requirement.

13. Financial accuracy of 99% for coding and payment of claims

Qualifications:

1. University education required

2. 2 – 3 years’ experience in medical administration, claims environment or customer service focused organization

3. Fluent in both spoken and written English and Mandarin

4. Preferable insurance background

5. Strong interpersonal skills with good verbal and written communication to internal and external client

6. PC literate; Solid knowledge of basic Microsoft applications to include Word, Excel and MS Outlook. Powerpoint is desirable but not required

7. Team work

8. Strong customer focus with ability to identify and solve problems

9. Ability to work under own initiative and proactive in recommending and implementing process improvements

10. Ability to organize, priorities and manage workflow to meet individual and team requirements.

中文：

1。准确反应时间内承诺给予的咨询方案设计、资格、申请状态和执行必要的行动要求，与首次呼叫解决尽可能。

2。在政策条款及条件要求满足个人和团队的生产力和质量目标。

3、监控的周转时间保证在规定的时间内解决索赔的尺度时，强调这是不可能实现的。

4. 监控和突出高成本要求和确保相关各方都知道。

5。提供支付担保需要客户和供应商。

6. 接口有效地与内部和外部客户解决客户的问题。

7. 与销售和客户管理团队提供开发服务客户密切合作。

8，识别潜在的改进工艺和适当的管理人员提出建议。

9，积极支持团队的所有成员，使所有的业务目标的实现提供资源

10. 性能指标会随工作时间增加熟练程度和复杂性。最初的生产力需要准确的反应或每小时15-20项目完成，包括一个混合的电话/索赔/传真/电子邮件）

11。达到或超过服务水平协议的要求。微创组在索赔或与客户的具体要求，按照10天的周转。这一数字将定期回顾，可以增加或减少，根据业务需要。

12。对于打电话要求质量标准将制定，沟通和会议，他们将生产的要求。

13，编码和支付赔款99%财务的准确性

万宝盛华大中华有限公司，1997年服务启航于香港和台湾。迄今服务覆盖上海、北京、广州、深圳等逾20座直营城市。我们的大股东万宝盛华全球（ManpowerGroup Inc. NYSE:***）是全球人力资源解决方案领导者，拥有70年服务经验。凭借万宝盛华全球的声誉及行业经验，万宝盛华大中华深耕本土20余年。2015年，万宝盛华大中华战略联盟中信产业基金，总部落地上海，服务网络覆盖两岸三地130余城市逾两万家企业。我们始终致力于释放人才的发展潜能，凭借灵活用工、人才寻猎、招聘流程外包、人才管理及培训发展等人力资源综合解决方案，广受业界赞誉，屡次荣膺“亚太人力资源领军企业”。