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Bayzat is the work life platform that benefits every company. We are redefining the way work works for the better, making automated HR, payroll, employee benefits and insurance a possibility for all businesses.
We are one of the fastest growing startups in the MENA region with 200+ team members from 30+ different countries.
The Claims team is an integral part of our business and we are looking to grow it.
What will you be doing?
- As a Senior Claims Analyst at Bayzat, you are responsible for a critical role in a driven team that is transforming the claims experience
- Assist in gathering customer feedback, defining processes, and identifying best practices
- Running experiments to identify potential solutions and sharing critical findings
- Collaborating with other departments to solve problems
- Refine claims experience including investigation, resolution and claim operations
- Providing value added customer service by resolving their issues, anticipating their needs and ensuring their satisfaction with the product and service norms
- Working on high ageing claims and reduction of claim life cycle
- Ensuring all insurer service levels are met
- Review email claim requests and direct customers to the App / Platform when applicable
- Review the set of claim documents for completeness
- Acknowledge the claim receipt & request missing information when necessary for insurer processing
- Update clients with status/delays on claims submitted
- Submitting claim via email or on the insurer portal
- Following up with the insurer for claim processing and claim summary
- Sharing claim summary / rejection with clients and explain if partial indemnification/ rejection.
- Answer Customer queries on Chat, Email or Phone when necessary
- Acknowledging the request on time
- Gather all relevant information from the member based on the pre-authorization request
- Follow up with the insurer until confirmation of the treatment request
- Confirm to the client the insurer decision
- Accuracy: Deliver a minimum of 95% accuracy on processed cases in the following areas:
- Document checking
- Requesting the missing/ additional documents from customers
- Email structure, client and insurer language and completion
- Quality & Clarity of explanation of the claim report for rejected/partially reimbursed claims
- Turnaround time: Achieving 95% accuracy on the below turnaround times for claims & pre-authorizations:
- TAT for document review of claims to be actioned within 1 hour
- TAT for submission of claim documents to the insurer to be actioned within 4 hours
- TAT for acknowledging a pre-authorization request to be actioned within 1 hour
- TAT for closing pre-authorization cases to be completed within 20 hours
- Claim Escalation: Escalate and appeal for eligible rejections to be overturned
- Share daily priorities with the team, prepare 1-to-1 and weekly performance review with management as peer agreed format (key metrics, projects updates, Q&A)
- Develop and maintain strong working relationships with Insurers through regular calls and catch-ups
1. Critical Thinking & Problem solving:
2. Medical Claims:
3. Pre-authorization requests:
4. Key Metrics:
5. Additional responsibilities:
What are we looking for?
- A minimum of 5 to 8 years of experience in a client servicing or operations role for an insurance / financial services organization
- Excellent verbal and written communications skills
- Have sufficient self-awareness to recognize the flaws in their own thought processes
- Obsessively organized, tech-driven, self-disciplined and detail oriented
- Excellent problem-solving abilities
- Competitive and hungry to be the best
- Ambitious, energetic, tenacious, and full of positivity
- Building strong relationships with colleagues, effectively collaborating across departments, and inspiring everyone around to do great work
- Experience working in a high-growth environment
