Team Lead

3 months ago

Dubai, United Arab Emirates Marsh McLennan Full time

Team Lead - Claims Advisory (Dubai)

**Company**:
MMC Corporate

**Description**:
**What can you expect**:

- Receive client complaints on delays in approvals for the medicines, and treatment procedures and coordinate with the Insurer to assist members by expediting the approval of treatments.
- Circulate monthly network updates and general circulars related to changes in the network.
- Reviews, understands, and assesses pre-approval assistance required by clients, informs all relevant parties of any potential problems or contentious claims, and seeks guidance or advice where necessary or refers to Claims Advisors/ Advocates to ensure the proper pre-approval of cases.
- Guides members on claims procedures to be followed for direct as well as reimbursement claims.
- Guides members on the claims process for home country or outside UAE treatment procedures and facilitates the approvals if mandatory as per the policy of the insured member.
- Portal submission assistance and resolution of portal issues.
- Prompt escalation of moderate/complex pre-approval cases to Claims Managers/ Senior Management to ensure effective outcomes as per client expectation
- All urgent escalations outside office hours are managed in a timely manner and as per the services agreed to meet the expectations of the top clients

**What you will be rewarded with**:

- We offer and embrace a hybrid working model that nurtures a collaborative working environment in the office 3 days per week allowing 2 days per week to be spent working on a remote basis.
- Competitive Benefits Package including 27 days annual leave, up to 4 days flexible bank holidays, excellent pension contributions, private medical cover, life assurance, income protection, employee assistance program, plus a range of flexible benefits including the option to buy or sell up to 5 days holiday per year, cycle to work, dental insurance, health assessments plus many more.
- Generous Family Leave including: 6 months paid maternity leave, 4 months paid paternity leave, 6 months paid adoption leave plus shared parental leave options. To help ease the transition when you return to work you will be able to work 8 weeks at 80% of your normal work pattern and receive 100% of your normal salary.

**We will rely on you to**:

- Allocation of new accounts, workload distribution of team, overseeing all the activities in the Helpdesk including monitoring of group mailbox per country, to ensure smooth and seamless delivery to clients.
- Direct Point of Contact for Client executives to escalate a sensitive case, request urgent case handling, and for VIP member case management
- Reviews the solution offered by executives for the escalations to ensure a high quality of work is being delivered by the team to maintain quality of service.
- Maintains relationships with insurers, third-party administrators, and underwriters,, Collaborates with Senior Management and client service team to advocate for direct reports internally as well as help them navigate moderately complex client interactions on claim/ approval cases.
- Tracks the progress of services offered and documents progress, on client transactions at a high level to ensure the team is meeting KPIs for the department.
- Daily review of denial cases, open beyond or nearing TAT cases and escalates cases to Head of Claims as per escalation protocol in place
- Prompt escalation of complex cases to Senior Management to ensure effective outcomes as per client expectation
- Weekly meeting with subordinates and with other team leaders, summarize the MOM and update actions with closure of open tasks within the next scheduled weekly meeting.
- All denials are reviewed and validated in line with policy and regulatory mandates, and discussed with client executives before the final update is shared with the client
- Mentors, coaches and connects the team with other colleagues and opportunities within the Company to help in their professional development.
- Trains direct reports on established business procedures and policies regularly and provides support on operational tasks & challenges to develop more effective staff.
- Ensure utilization of team leaves and its reporting on workday.
- Monthly check-ins with the team, performance tracked against KPIs and shared on Workday, Individual Development Planned for the team and followed through to ensure progress against same through the year

**What you need to have**:

- 10+ years of experience as Helpdesk Managers in relevant roles and industry
- Excellent verbal and written communication skills
- Excellent computer skills, time management & negotiation skills.
- Excellent knowledge of market developments and regulatory updates.
- Excellent knowledge of various Insurers' claims process and claims adjudication criteria
- Excellent Leadership, change management & Analytical skills
- Excellent Computer skills, time management and negotiation skills.
- Excellent Complaint resolution, Crisis management and Cli

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