To provide advice, sound judgement and recommendation on case of admission that surpasses the authority of a Healthcare Operations Senior Officer.
To authorise, deny and determine extent of insurer’s liability on case of discharge that surpasses the authority of a Healthcare Operations Senior Officer.
To assist and / or provide guidance to Healthcare Operations Senior Officer as and when required
To plan and undertake thorough investigation of possible frauds and potential subrogation, to record results of examination or investigation and report to Head of its findings.
To identify control weaknesses and implement solutions and controls for future improvements.
To execute SOPs, best practises, ISO policies and ensure compliance with policies. This shall include compliance of legislative requirement such as data protection and medical confidentiality.
To interact closely with other department providing an understanding of how company functions as a whole. To take up any other tasks as deemed fit or as assigned by Head as and when needed.
To oversee after- hours (8pm to 8am) Mediclinic work. This shall include the need for verification of customer and benefits, Issuance of outpatient LG and respond to phone calls.
To conduct Quality Assurance / Control on regular / routine basis ensuring efficiency, effectiveness and performance are always achieved and maintained in accordance to SLA set- forth by the clients.
To report the status of the quality levels of Healthcare Operations Senior Officer / Healthcare Operations Officer and their competency level and identify the areas requiring enhancement.
This shall include proposal to Head for Authority review or suspension.
To conduct audits of ISO policy and compliance of standards as and when needed and / or as assigned by Head / Manager.
To identify training needs and solve specific training problems, either on a one- to- one basis or in groups.
To highlight issues related to Schedule of Benefits with suggestions for improving Claims related documents and templates.
This shall include designing and maintaining new document templates for daily usage.
To record and monitor staff performance in accordance to the KPIs set- forth by the company. To appraise, and provide proposal of staff promotion and / or remuneration to Head / Manager.
To record and monitor the trend of minor misconduct issues i.e. late coming and absenteeism. To report to Head / manager for any repetition.
To witness a Counselling Session and to provide advice for staff involving in any misconduct.
To actively participate in regular team meetings, provide feedback and support to Head / Manager for day to day operational related matters / issues.
To work closely with IT for the maintenance and upkeep of systems ensuring day- to- day operation runs smoothly without interruption.
To be responsible for the readiness, reliability and stability of systems and systems related operating facilities.
To involve in risk management, which includes analysing, identifying, evaluating and estimating the risks which may affect the continuity of business.
To work closely with Head / Manager to execute and initiate Business Continuity Plans (BCP).
Assist or provide guidance to Healthcare Operations Senior Officer / Healthcare Operations Officer from call escalations as and when required.
Respond to e-mails and faxes within agreed client SLA.
Respond to phone calls from clients.
Minimum qualification : Degreein relevant field.
Minimum experience : 5 years in the Healthcare Operations
Leadership exposure withsimilar capacity is a MUST.
Good level of Communication
A collaborative and flexiblestyle, with a strong service mentality.
Technical / FunctionalKnowledge, Skills and Abilities
Other Role SpecificCompetencies
Good communication skills inEnglish, Bahasa Malay.
Ability to multi-task and workin a fast paced environment.
Possess good general knowledge and the abilityto handle stress and work with minimal supervision.
What We Offer
By joining AXA Partners, you will work in a responsible company, which offers a real culture of expertise & diversity. Our focus is on accelerating the development of everyone’s skills, whilst offering attractive and competitive compensation and opportunities for professional development and growth.
Additionally, at AXA, we work to make a real difference to people - when amazing things happen and when we create opportunities for a better life, the feeling of pride is extraordinary.