Claims Manager
hace 1 mes
Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply
Our people make all the difference in our success.
Somos una empresa multinacional de seguros de salud con mÃs de 170 millones de relaciones con clientes y pacientes en mÃs de 30 paÃses y jurisdicciones.
Somos una organización humana, donde las personas son lo primero. Ya se trate de nuestros clientes, asegurado/as o compañero/as, nuestro objetivo es mejorar la salud, el bienestar y la tranquilidad de las personas.
AsÃ, las relaciones sólidas con los clientes son nuestro objetivo principal, y creemos firmemente en la ética empresarial.
Nuestro éxito se lo debemos al talento y la dedicación de nuestro equipo. Ellos son quienes marcan la diferencia en la vida de nuestros clientes. Asà que sabemos que es importante hacer un esfuerzo adicional para nuestros empleados. Nos aseguramos de que tengan un buen equilibrio trabajo-vida y ofrecemos numerosas iniciativas para la salud y el bienestar.
Descripción del Puesto
Con reporte directo a la Dirección de Operaciones de la CompañÃa, el/la Claims Manager gestionarà una función clave en la CompañÃa, dirigiendo un equipo de entre 20-25 personas y responsabilizÃndose tanto de la gestión diaria de la función de prestaciones como de impulsar la transformación digital y modernización de la misma.Â
Responsabilidades del Puesto
- Organizar y supervisar al equipo encargado de la facturación de proveedores médicos, bien sea por medios telemÃticos o de facturación no mecanizada. Coordinación de recepción de facturas, establecimiento de controles y control de los niveles de inventarios en cada estadio de facturación, asà como supervisión de los trabajos de grabación de los equipos de procesamiento.
- Gestionar las relaciones externas con proveedores médicos (hospitalarios y profesionales independientes) al nivel de los procesos de facturación, asà como de terceros intervinientes en la interoperabilidad de la compañÃa, fomentando siempre la eficiencia y automatización en los procesos.
- Mantener y mejorar los KPIâs de actividad, incluyendo los niveles de calidad de servicio, control de los inventarios, los plazos de facturación, niveles de automatización y productividad interna, asà como contribuyendo a la mejora de los procesos de facturación mecanizada y del auto-pago.
- Reportar periódicamente los resultados y niveles de actividad, con un enfoque analÃtico que contribuya a la toma de decisiones inmediatas en el Ãrea, asà como identificando oportunidades de mejora en el medio y largo plazo de la función.
- En coordinación con las Ãreas Financiera y de Gestión Asistencial, gestión de las reconciliaciones y ejecución de deudas pendientes con proveedores médicos.
- Coordinación con terceros en la gestión de recobros por accidentes.
- Liderazgo y/o participación en iniciativas internas transversales con otros equipos y/o departamentales en la función, bien sean de carÃcter local o internacional.
Requisitos
- Experiencia mÃnima de 5 años en puesto de perfil similar en el ramo asegurador de Salud, con un profundo entendimiento del impacto de los procesos de facturación en el negocio asegurador y, concretamente, en el Ãmbito de las reservas financieras.
- Persona habituada a la gestión equipos de lÃnea de tamaño medio, a la interlocución continúa con proveedores y terceros, y a la participación en iniciativas transversales de compañÃa.
- Persona proactiva, resiliente y rigurosa, con claras habilidades de trabajo en equipo, que conjugue bien la gestión diaria de la función con el carÃcter transformacional requerido en la misma.
- Orientada a la mejora continua, a la optimización de procesos y a la mejora de la productividad, con conocimiento y uso habitual de herramientas de anÃlisis y reporting (Qlikview o similar), de aplicaciones de back-end asegurador, CRM y paquete Microsoft Office.
Cualificación
- Cualificación mÃnima de grado universitario (preferiblemente ADE, Económicas).
- Se valorarà postgrado relacionado con la función o generalista de management (MBA, programa directivoâ¦).
- Nivel avanzado de inglés.
Ofrecemos
- Contrato indefinido e interesante proyecto profesional en compañÃa multinacional.
- Atractivo paquete de compensación total que incluye salario fijo y variable, asà como los siguientes beneficios:
- Seguro de Salud
- Ayuda a la comida
- Plaza de parking
- Plan de Pensiones
- Desarrollo profesional, ayudas a la formación y diferentes iniciativas y beneficios relacionados con tu salud y bienestar.
Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link
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