Beneficiary Relations Specialist (For a client of People Dynamics) - iHorizons

A Beneficiary Relations Specialist who reports to the Senior Beneficiary Relations Specialist at Customer Service Section and will be performing the following duties:
• Develop a customer service policy for an entire organization in alignment with designated PIH.
• Handle face-to-face enquiries from customers and provide help and advice to customers about health insurance coverage and services, in particular investigate and solve customers' problems, which may be complex or long-standing problems that have been passed on by customer service staff.
• Keep accurate records of discussions or correspondence with customers.
• Analyze statistics and prepare reports on customer service.
• Develop customer service procedures, policies and standards.
• Meet with other department officers to discuss possible improvements to customer service
• Interact with customers to provide information in response to inquiries about products and services and to handle and resolve complaints.
• Interact with customers by telephone or in person to provide information about products or services or obtain details of complaints. Discuss services information with customers or patrons.
• Respond to customer problems or complaints, follow up and ensure that appropriate changes were made to resolve customers' problems.
• Maintain financial or account records by keeping records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken
• Refer customers to appropriate personnel and refer unresolved customer grievances to designated departments for further investigation.
• Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments and provide notifications.
• Review customer insurance information and check with insurance table of benefits to determine whether a particular loss is covered by insurance or not.
Nature and Scope of the Position:

1. Represent the Social Health Scheme and liase with any walk-in customers (predominantly members; relatives; potential future members; employers; sponsors)
2. Explain the government’s rationale for introducing mandatory health insurance in the State of Qatar and the resulting advantages for citizens
3. Provide information and clarification related to benefit packages, SHIS policies & procedures, and premium levels
4. Furnish information related to which providers are in the SHIS Provider Network and the services they offer
5. Accept complaints related to PHI, Network Providers, comforting complainants and escalating complaints where necessary
6. Resolve simple disputes on the spot; ensure smooth interaction between the PHI, HFID and the customer
7. Interact with customers to handle complaints, process orders, and provide information about health insurance products and services.
8. Receive query or requests from customers or the public. They typically provide services by phone, face to face or by email.
9. Incumbent has the ability to review customer’s policy to answer questions regarding coverage and claims.
10. The incumbent will be making local and international phone calls during and outside of the working hours, as necessary in order to facilitate and expedite outcomes.
11. The incumbent will be attending meetings, conferences and workshops, and give presentations to address any issue related to his/her job, whether within the premises of  or in any locations within Qatar, or even internationally

Job Details

Preferred Candidate