My client is looking for a Operations Executive with ITALIAN
DUTIES AND RESPONSIBILITIES
Efficiently investigating and processing claims, administering the validation of medical subscriptions, efficiently answering phone calls and emails from customers and partners. Being proactive in supporting the implementations of processes and procedures with the aim of streamlining these activities. Also, providing business support on all operational aspects within your team and your department. Managing medical subscriptions cases, handling and resolving complaints for PPI business. This job description relates to all partnerships.
Claims:
· Assess and process claims within the PPI portfolio according to relevant policy terms and conditions.
· Process and decision claims over the delegation for all businesses based on recommendation received from TPA and according to the relevant policy terms and conditions. Confirm approval to TPA.
· Check monthly reporting per partner for its accuracy and completeness
· Check Claims transfer request forms and sign off monthly/weekly confirming accuracy
· Maintain an individual internal quality level > 95% on a monthly basis
Customer Service:
· Answer incoming calls, assess the urgency of the call, appropriately prioritize and escalate if necessary according to established procedures to ensure optimal quality customer service.
· Perform Outbound to customers and Business partners when necessary after Supervisor approval
· Maintain call accepted rate within SLA
· Ensure calls are answered within SLA
· Ensure timely follow up is completed on all post call administration
· Ensure quality answers are provided to customers and a level of professional response is provided at all times
· Maintain an individual internal quality level > 95% on a monthly basis
Partner Management:
· To provide customer service support for the business portfolios according to SLA.
· Travel on Operational visits to partners with Team Leader/ Operations Manager ensuring prior organization by means of Agenda and Minutes to be circulated on return.
· Liaise with all partners in order to provide follow-up trainings and clarification on operational queries, understanding of policy wording and/or working processes via conference calls or emails.
· Relationship building and ongoing management is a large part of this role.
Projects:
· Participate in any projects related to your market including but not limited to – new product implementation and ongoing administering, new partnership implementation and ongoing administering
· Training related to day to day business, training of new partnerships, new product training internally within the team/department or within the partnerships
Business Support:
· Assist in creating and updating procedures as and when necessary, for new and existing business.
· Assist the Team Leader in insuring that all business documentation for the department is up to date, filed and archived.
· Present suggestions for reviewing and updating procedures to Team Leader and implement, coordinate, and monitor any upgrades to procedures as they are signed off.
· Provide training both internal & external
· Maintain various regular and ad hoc reports and provide to your Supervisor.
· Perform other work or projects as and when selected by the Operations Teams Leader or Operations Management.
Complaints (if applicable):
· Log all customer complaints sent directly to CACI Life/Non-Life or indirectly via TPA using Respond System.
· Review the complaint and process same within delegation authority. For cases above the delegated authority, prepare a recommendation for sign off via escalation route according to complaints procedure.
· Analyze and report all third level complaints internally
· Coordinate, monitor and report all legal complaints/summons following the complaint procedure
Medical Subscriptions (if applicable):
· To administer subscriptions input and validation following recommendation from medical underwriters.
· To ensure proper communication between the team staff in the Dublin office, the local TPAs, and medical underwriters to ensure timely decisions are communicated to the partners following service standards.
INTERFACE
· Insurance Division: Dublin Management Team and Insurance Division in France (Administration, Business Development and other services)
· Group: Group claims & subscriptions departments
· External: Partners in Europe: Finance Companies & TPA.
Experience and Qualifications
· Any relevant qualification
· 2 to 3 years’ experience in Claims handling, Complaints resolution competencies would be an advantage.
· Minimum 2 years’ experience in customer service
· Customer service oriented
· Fluency in both English and Italian fluency a necessity
· Travelling to France and other European countries occasionally
If you are interested, send your CV to [email protected] or apply directly here!