Medical Insurance - Team Leader

Oversee day-to-day health dept. operations with focus on membership and premium management. Supervise underwriting from risk assessment to policy issuance. Ensure full compliance with laws, internal policies, and ethical standards.

Main Responsibilities:

-        Enroll members in the health insurance plans, which may include verifying eligibility, processing applications, and explaining plan benefits to clients and intermediaries.

-        Ensures the renewal process for existing clients and members, including follow-up and processing renewal applications.

-        Attends to questions or issues with the client’s health insurance plans. Answers questions, troubleshoot problems and escalate issues if needed.

-        Maintains accurate records of all members, including demographic information, plan coverage, and claim history.

-        Works closely with other colleagues, such as claims processing, customer service, and provider relations, to ensure that members receive the highest level of service and care.

-        Educate members about their health insurance plan, including plan benefits, excess, policy exclusions, and other important details.

-        Issues Debit Notes and follow-ups of payment

-        Follow up of Debtors and Issue monthly Statements of Accounts.

-        Ongoing reconciliation of membership premiums.

-        Any other cognate duties that might be assigned

Academic Qualifications:

• Bachelor's degree or equivalent qualification.

Functional skills:

• Answers customers in a friendly, professional manner and attends to e-mail inquiries in a timely manner.
• Have good communication and interpersonal skills.
• Team Spirit: Helps the team in case of backlog.
• Ensures compliance by following company policies, procedures, and guidelines

Key competencies:

• Attentive to details
• Fast processor with objectives to meet Turnaround time as per SLAs.
• Accuracy in data capturing.
• Continuous Innovation
• Ownership & Commitment