Description

Job Title: Senior Processor Executive / Team Lead (Insurance - Provider Relations) - Cantonese

Location: Malaysia

Language Requirement: Must have proficiency in Cantonese (Verbal and written)

Summary:

Senior Processor Executive:

Handle enquiries from network providers including but not limited to card acceptance / PA / outstanding claim status / contractual & fee review

Provide administrative support including but not limited to report generation / system updates & maintenance / claim status checking / calls to network providers as ad hoc request / maintenance of network summaries / voucher request handling

Provide administrative support including but not limited to report generation / system updates & maintenance / follow-up with network providers via email / communication with Claims for processing

Team Lead:

Oversee and supervise subordinates in their day-to-day activities, to ensure contract compliance activities are carried out.

Oversee and supervise subordinates on admin support and network healthcare provider data maintenance in PCMS system, to ensure contract compliance activities are carried out.

Job Responsibilities and Expectations

• Handle phone call and email enquiries from our network provider regarding the medical cards, pre-authorization, referrals

• Handle enquiries related to contract renewal, fee review, portal access and movement notice

• Provide information on pre-authorization status, Guarantee of Payment Letter and claims

• Update and maintain accurate records of all inquiries and provider list

• Generate different reports and network summaries on regular and ad hoc basis.

• Handle movement notices and update internal systems.

• Create and maintain provider records, provider related codes and contract details in internal systems.

• Support onboarding of new providers.

• Send notification email to internal parties on ""Large Hospital Claim"" cases.

• Handle contract renewals and maintain system reference data.

• Check claims status upon receiving enquiries from network providers.

• Ensure all data entries and system updates are accurate and completed on time.

• Make calls to network providers upon ad hoc request.

Team Lead:

• Oversee and supervise subordinates on day-to-day activities. Manage the Team to perform the duties accurately and efficiently.

• Monitor performance of the team to ensure delivery of agreed KPI.

• Provide regular training to staff and new joiners.

• Maintain standard operating procedures in the team up-to-date and ensure the team's compliance to the agreed processes.

• Conduct regular communications and provide coordination with Team on the services. Establish internal escalation workflow.

• Make clear and justifiable decision and escalate to HK Team when (and only when) necessary.

• Prepare performance reporting for review on regular basis. Handle ad hoc tasks assigned by Team.

Desired Experience:

• With 1 year of experience in provider relations or health insurance

• Good communication and negotiation skills. Good analytical and problem solving skills

• Detail-minded and willing to accept new challenges

Team Lead:

• With at least 4 years of solid experience at Team lead level in provider relations or health insurance

• Strong sense of continuous improvement and desire to deliver quality outputs; strive to over-deliver on SLAs to improve and enhance work efficiency and quality

• Exceptional communication and negotiation skills.

• Strong analytical, problem solving and root cause identification skills and strong attention to detail

About Cognizant :

Cognizant (Nasdaq: CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at www.cognizant.com or @cognizant .