Who we are:
Known as the Work Life Platform, Bayzat is one of the leading employee benefits SaaS platforms that is on a constant mission to make a world class employee experience accessible to 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 just over 300 members from 35+ different nationalities. We were listed by Forbes as "One of the most promising UAE-based startups" and are backed by world leading VCs such as Mubadala and Point72 ventures. We are also one of the best-funded scale ups in the HRTech space across the region.
We are a principle-led, meritocratic company that puts culture at the core of everything. As a Bayzat member, you will constantly be surrounded by high achieving individuals and teams who have a knack for solving complex problems and are relentlessly pursuing success in everything they do. Being part of such an environment will push you to constantly be the best version of yourself and capitalize on every opportunity to improve, whilst drawing inspiration from like-minded, hungry people from all around you
How we got to where we are today, and the reason we will continue to thrive, is by hiring best-in-class talent and building a culture that allows people to be the truest, most authentic and unpretentious versions of themselves.
The Operations team is an integral part of our business and we are looking to grow it. We are looking for a dynamic, goal-oriented and efficient Claim Analyst to support the growth of our portfolio and build a great customer experience.
The Claims Team manages the operational processes deriving from medical insurance customers claims for reimbursement and pre-authorization requests, as well as attends clients inquiries on coverage and claim process.
Our mission is to support our customers throughout the medical claim process, as well as guiding them on the utilization of their plans benefits through a highly efficient and customer-centric approach, leveraging on technology, processes and team organization.
What will you be doing?
The below outlines the corresponding responsibilities of a Claims Analyst but does not represent an exhaustive or complete list of activities:
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
a. Accuracy: Deliver a minimum of 95% accuracy on processed cases in the following areas:
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
b. Turnaround time: Achieving the below turnaround times on 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 2 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
Escalation Matrix: Escalate insurer delays/rejections raised by account managers
Reporting and Other Tasks
Salesforce CRM management
a) Create and update cases in salesforce upon processing of a new claim case
b) Manage individual reports to review & process assigned tasks/cases within set TAT
c) Consistent use of SF dashboards to set daily priorities, maintain a clean pipeline and manage deadlines
Reporting: 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)
a) Update and review processes, insurers claim guides and new insurer products.
b) Share regular feedback and suggestions to Operations team as well as the Commercial Team
Develop and maintain strong working relationships with Insurers through regular calls and catch-ups
What are we looking for?
A minimum of 2 to 5 years of experience in a client servicing or operations role for an insurance/financial services organization
Excellent verbal and written communications skills
Obsessively organized and detail oriented
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