AN/019 2018 Health Insurance Assistant
Posted on June 19, 2018 by IOM
Under the direct supervision of the Insurance & Provider Specialist, IOM Geneva, general supervision of the Head of PAC and in close coordination with the Health Claims Processing Unit in Manila (HCP-MAC), the Health Insurance Assistant will be responsible for the administration related to the claim processing for field staff and their eligible dependents based in Africa and the Americas
Core Functions / Responsibilities:
·Evaluate eligibility of staff members and his/her dependents for MSP admission and coordinate with the Country office for the admission date, correct records in PRISM.
·Coordinate with the Health and Insurance Medical Unit (HIM-PAC) and with the Human Resources Administrative Services (HRAS) in the Panama Administrative Centre for the approval of the MSP admission forms. Inform Country Offices of newly admitted participants.
·Check quarterly report and coordinate with Country Offices for any discrepancy on the admission date of participants.
·Receive and record claims submitted by mission for verification purposes.
·Scrutinize the medical claims for eligibility in the insurance schemes from the financial, administrative and technical stand point.
·Evaluate supporting documentation thoroughly:
(bills/invoices/prescriptions/proof of payment), from Country Offices and ensure conformity with insurance regulations, coverage and entitlements.
·Ensure correctness of claim data in the database, appropriate currency conversion, and accuracy of calculation print confirmation for files and to be sent to the retired participants.
·Generate monthly payment authorizations to field missions and ensure the timely payment of reimbursements.
·In coordination with the Medical Officer in PAC, provide authorization for direct payments of high medical bills to Country Offices and issue guarantee letters to hospitals.
·Distribute MSP insurance cards to Country Offices.
·Provide guidance, instructions and explanations regarding entitlements, procedure for submission of claims and reimbursements.
·Maintain and manage the claim files.
·Verification of all members’ information consistency in PRISM regarding contract information, correct dates of admission into MSP, deduction for dependents according to age, marital status, etc. Further coordination with HRAS and Country Offices in America/Africa to apply corrections/modifications.
·Random verification of medical institutions in coordination with HIM to minimize and locate possible fraud.
·Constant coordination and updating of our focal points on MSP rules and procedures. Eventual group meetings (tele/video-conference) with staff and focal points for updating and solving most frequently asked questions and doubts as well are personal queries.
·Issuance of Certifications of Medical Insurance Coverage for staff on official travel, escort of migrants, escort of medical cases and travels for training purposes.
·Maintain and manage files for the admission of staff and dependents into MSP
·Prepare monthly correspondence to distribute the forms of reimbursements of claims processed.
·Generate and submit quarterly reports and statistics on all duties
·Prepare and provide information from field staff and dependents in the Americas and Africa for investigations and for the generation of reports for submission to the Insurance Administration, whenever needed.
·Perform any other duties as may be assigned.
Required Qualifications and Experience
Education & Experience
- University Degree in in Business Administration or related, in the medical field or apprenticeship with an insurance company plus two years in related area is an advantage.
Completion of secondary education with minimum four years of relevant experience in,
·Develop and maintain effective work relationships within and outside the Organization
·Preferably in insurance administration and claims processing,
·Training in insurance matters, preferably in the health area, an advantage
·Planning and prioritize tasks in order to adjust own schedule to meet additional and/or unexpected demands and deadlines
·High-level computer literacy
·Spanish : Fluency
·English : Working knowledge
·French: Working knowledge is an advantage
- Accountability – takes responsibility for action and manages constructive criticisms
- Client Orientation – works effectively well with client and stakeholders
- Continuous Learning – Promotes continuous learning for self and others
- Communication – Listens and communicates clearly, adapting delivery to the audience
- Creativity and Initiative – Actively seeks new ways of improving programmes or services
- Leadership and negotiation – develops effective partnerships with internal and external stakeholders;
- Performance Management – Identify ways and implement actions to improve performance of self and others.
- Planning and Organizing – plans work, anticipates risks, and sets goals within area of responsibility;
- Professionalism - Masters subject matter related to responsibilities
- Teamwork – Actively contributes to an effective, collegial, and agreeable team environment
- Technological Awareness - Learns about developments in available technology
Any offer made to the candidate in relation to this vacancy is subject to funding confirmation.
Appointment will be subject to certification that the candidate is medically fit for appointment, accreditation, any residency or visa requirements, and security clearances.
How to apply:
Interested candidates are invited to submit their applications via e-mail to PAC-Recruitment@iom.int, by July 3, 2018 at the latest, referring to this advertisement.
For further information, please refer to http://panama.iom.int/en/vacancies and http://ciudaddelsaber.org/es/oportunidades/empleos
In order for an application to be considered valid, IOM only accepts documentation duly completed (resume in the format attached and intention letter).
Only shortlisted candidates will be contacted.
From 20.06.2018 to 3.07.2018