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This role works closely with the CS Operations Managers to help keep the business operations running smoothly. Under the New Business Processing setting, he/she shall be responsible in all activities relating to new business requests and ensuring that all new businesses are properly recorded in the system. He/she shall also facilitate evaluation and obtaining approvals of individual member beyond the No Evidence Limit (NEL). He/she may also be assigned to helpdesk servicing specific to group medical accounts. Under the Policy Member and Administration setting, he/she shall be responsible in all activities relating to post new business servicing activities. Under the Claims setting, he/she shall be responsible in the review of accuracy and completeness of the received claim forms and documents. He/she also works closely with different work units to facilitate adjudication, approval and settlement of claims.

1. Observes the following line of authority:

• a. Division Head: Corporate Solutions  

• b. Department Head: Corporate Solutions - Operations

• c. Unit Head: Corporate Solutions – New Business Processing or; 

• Unit Head: Corporate Solutions – Policy and Member Administration or; 

• Unit Head: Corporate Solutions – Claims and Operational Efficiency 

2. Main Functions

New Business Processing

• Evaluates  New Business Requests and requirements

• Creates and maintains new account records in the system

• Sets-up of policy and member records in the system

• Allocates premium payments

• Generates  Initial Billing

• Releases Policy Contracts and Initial Billing to Agents and/or Clients

• Evaluates individual members beyond the New Evidence Limit (NEL) and facilitation of requirements and approvals thereof

• Performs helpdesk servicing specific to group medical accounts

Policy and Member Administration

• Evaluates policy changes and/or member movement requests and validates pertinent documentary requirements

• Updates client/policy information in the system

• Reconciles current and updated member records

• Creates Policy Endorsements

• Creates of Renewal Bills

• Reconciles over/under premium payments in the system

• Release Policy Endorsements, Renewal Bills and Certificates of Cover

Claims Receiving and releasing

• Evaluates accuracy of claims and completeness of claims documents  

• Sends advice of lacking requirements to clients/agents/brokers (if applicable)

• Registers received claims in the system

• Coordinates adjudication/approval of claims to Life Operations - Claims 

• Facilitates release of claims checks/payments of all Home Office filed claims

• Handles claims inquiries

3. Other Responsibilities

• Performs other responsibilities and duties periodically assigned by supervisor in order to meet operational and/or other requirements 

MINIMUM JOB REQUIREMENTS

• Education – Graduate of any 4 year College Course

• Experience – At least two (1) year experience in client servicing 

Build a career with us as we help our customers and the community live healthier, longer, better lives.

You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.