wessam Mohamed Abdel Aziz

Claims & Technical ManagerFull Time

• Job Details:Role Profile:  Regional responsibility in managing the claims’ function, reporting to H.O in Hong Kong.  Regional responsibility in managing the medical TPA in terms of negotiations, contracts, expansion, cost containments, case management.  Direct the management of Technical Department including Claims and Group Operations in terms of setup, procedures, functions and guidelines.  Lead, Coach, strengthen teamwork and improve professional competence of the group operation to enhance Quality, service, increase Group staff productivity and shorten TAT.  Establish strong and effective network, lead the identification, selection, evaluation, negotiation, contracting and re - contracting process of health care service providers within the established corporate guidelines to ensure that all services are provided cost efficiently ensuring optimum protection company’s business interests.  Maintain effective business relationships with clients and all service providers (network members, insurance companies etc) to ensure the services required by the organization are delivered in the most effective manner.  Cultivate and maintain excellent relationships with re-insurers, customers, clients, TPA and regulators, and developed cost-containment initiatives.  Ensure Claims decisions are in accordance with policy provisions and established authority limits with prompt claim settlement, involving reserve establishment, reinsurance action.  Determine need & level of investigation and plan required action.  Monitor loss experience and provide suggestions for corrective action.  Ensure that all guidelines and procedure set are compliant with Chubb Life guidelines and code of conduct.  Establish contact with legal consultant to determine his respective involvement within established guidelines.  Coordinate with the sales team in terms of pricing, networks solutions, claims issues and product design.

Head of Pre- AuthorizationFull Time