JOB OVERVIEW:

The main duty of a Travel & Assistance Officer is to manage the claims cycle about the Travel & Assistance products / services by following standard protocols respond to telephone / e-mail inquiries and. The incumbent is also responsible to ensure all KPI’s are achieved & dealt with the highest standards of customer service. The Department will keep a record document details of telephone conversation and actions taken, in order to make further follow-ups and corrective action as required. The Travel & Assistance Officer will work closely with the Travel & Assistance team and management ensuring that all defined standards are met with excellent customer services standards.

• Manage the assigned tasks related to medical assistance cases.
• Evaluate medical claims according to the guidelines.
• Coordinate with different providers to ensure high quality of service when organizing medical assistance.
• Respond inbound and outbound telephone / e-mail Customer / Partners inquiries and ensure call quality monitoring
• Claims evaluation and processing activities such as checking policy, eligibility, claims creation in the system, follow up upon ongoing claims ensuring the requested turn around time and processing of claims and other tasks related to claims management
• Assist callers on claims process / procedure / network inquiries, explaining policy terms & conditions
• Accommodates Business Units / Travel / TPA International requests with regards to opening international files, placement of Guarantee of Payment, etc.
• Follow the complaints & escalation management process and log in complaints with action & resolution in the system / tools provided by the company
• Ensure proper system related tasks as creating files and Service Providers updates on the portal
• Record tasks in the productivity file, share with management and ensure reaching the level of productivity assigned
• Follow the internal processes and guidelines to ensure reaching the Operational KPIs (Quantity and Quality) and the attendance KPIs
• Request feedback in relation to the performed tasks and discuss with Team Leader the monthly scorecard results
• Monitor daily activities as per the communicated Service Level Agreement, create reports / statistics / analysis and report any deviation
• Attend training sessions as requested and participate in the departmental activities in accordance with the monthly schedule
• Attend internal meetings related to the job as per the internal requirements