Claims Analyst & Training Specialist
United Arab Emirates/Dubai
- Proficiently analyze and authorize health insurance claims, ensuring strict adherence to Terms & Conditions (T&C) and individual Table of Benefits (TOBs).- Consistently achieve high accuracy rates, minimizing errors and maximizing operational efficiency.- Maintain records and confidentiality of customer inquiries and build long-term customer relationships to achieve successful resolution of queries.- Analyze various parts of client problems and devise suitable solutions within the permitted scope of work.- Generate customers' interest in services and products offered by the company.- Define the development needed to support achieving the operational objectives and conceptualize training materials and methods based on data and research, including compliance, SOP, MOB, etc.- Recommend changes to course material and training manuals to meet specific training needs.- Assessed employees skills, talents, performance and productivity, prepared evaluations and made recommendations for improvement.- Proactively measure agent performance and conduct individual/group training sessions to address skill gaps effectively.- Utilize analytical insights to identify areas for improvement, enhancing overall efficiency and accuracy and analyze various parts of client problems to devise suitable solutions within the permitted scope of work.- Conduct thorough and precise internal quality assurance audits to ensure compliance with industry regulations and company policies, and act as a liaison between different departments and stakeholders, ensuring seamless communication and collaboration.