Sr. Specialist - AAGI Partnership Sales Admin & Reporting

Job description

1. Support team in managing sales support activities to drive and push sales to achieve target for Bancassurance Channels (e.g. launch of new product, promotion, contest or sales activities and customer campaign)                                                                                                        
2. Work with team to prepare and launch the appropriate sales supporting tools to Bancassurance channel (e.g. brochure, quote express, soft file for selling products) to a high quality and in a timely manner                                                                                                        
3. Work with team to manage communication materials as well as all sales support processes for Bancassurance channel                                                                                                        
4. Develop new innovative sales tools and make enhancement to existing tool and product promotion material                                                                                                        
5. Track and monitor to ensure that all sales activities are in compliance with department objectives and goals, the company’s Corporate Brand Identity, and regulations                                                                                                        
6. Ensure that each contest/promotion is aware by the right target group via advance communication                                                                                                        
7. Ensure that stakeholders are motivated during the contest by tracking and monitoring the report of the performers and communicate to them                                                                                                        
8. Communicating and distributing of product material, new sales tools to sales force and target audience for Bancassurance channel                                                                                                         
9. Work closely and aligned with sales channels to define communication needs to support achievement of targets                                                                                                        
10. Define the strategy and guidelines for sales communications for Bancassurance sales channels                                                                                                        
11. Define the objectives, plan sales communication activities and define the target audience for Bancassurance sales channel

12.

Job Summary :

Being responsible for Pre-authorization process here are 2 parts which are pre-arrangement part (pre-approve for procedure/surgery) and admission part (initial approval for admission). We service both providers and members each day as shift work from 8 am – 5 pm every day.We pay more attention both medical necessity and cost containment to control the treatment cost in a procedure which the providers have the package price. These process make the customers have a good benefit management under customary price and our business get more cost saving

1). Reviews claim and medical reports (medical indication assessment)  
-  Verify the eligibility of the claim by using and applying the medical knowledge to pre-arrangement cases.
-  In case of medical issues such as medical necessity for the procedures have to consult medical consultant team.
-  Applies all medical necessity guidelines (Thai Medical Practice Guidelines), determine coverage and apply all cost containment measures.
-  Sending the criteria checklist to consultant doctor and benchmark price & LOS comparison.
-  The conclusion and issuing the confirmation letter to the providers within SLA (3 days)
-  Control the cost-effectiveness of medical care and ensure that any new clinical procedures, drugs or technology are appropriate and safe for our customers.
-  Study and understand A&H policy & coverage to apply pre-arrangement and admission part.
-  Coordinate with Internal team such as corporate key account, care coordinator, Medical  team, and External team such as utilization nurses from the hospital.

2). Collaboration process with Health Concierge, Health Solutions & Care Coordination team step as below ;
-  Screening the case which meets the criteria for collaboration project or package.
-  Sending the criteria checklist to consultant doctor.
-  Benchmark price & LOS comparison.
-  Package price checking of each provider.
-  Provider negotiation.

3).Detects suspicious, fraud or abuse claim by providers and refer to Clinical Governance Team. 
4).Process Cooding (ICD codes) based on medical procedures and the claim process

Quaifications :

1. Minimum 3 years in related field
2. Insurance knowledge is a plus
3. Able to work in commercial environment and fast moving business.
4. Excellent interpersonal and communication skill

5.Any AI-future skills e.g., ChatGPT, or CoPilot 365, will be an advantage

     .