Team Lead, Medical Case Assessor
5 days ago
About the team
Doctor Anywhere's Operations team is a crucial part of the company. We ensure the day-to-day excellence of our TPA business, virtual and in-person clinical services, resolving operational issues in a timely manner and providing the best customer experience possible. We make sure that our customers remain our top priority.
About the role
This role reports directly to the Senior Manager, Contact Centre.
A summary of the key responsibilities are as follows:
- Lead the case team to assess inpatient case assignments and to approve or decline Letter of Guarantee or pre-authorization requests.
- Work closely with Specialists, Clinics and Hospital groups in relation to the Letter of Guarantee or pre-authorization requests.
- Ensure any suggested treatment plans fall within policy terms and conditions.
- Maintain accurate case records and all related communication.
- Be exposed to data analytics tools as part of your assessment work.
- Any other special projects and ad-hoc duties assigned when appropriate.
About you
- Diploma/Degree, preferably within studies of Bio-sciences, Nursing or Statistics.
- Experience in Healthcare/Insurance/Third-Party Administrators industries is a must.
- Ability to communicate clearly in both writing and verbally.
- Ability to handle and mediate sensitive issues calmly, empathetically and professionally.
- A start-up attitude - you take full ownership of things that you do, willing to go out of your comfort zones and take on new challenges.
- Comfortable with ambiguity - we are a fast-growing business and there's always unchartered territories, which is part of the fun. You should be comfortable with it and understand that not everything is 100% defined all the time.
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