Medical Operation Executive

About Amanleek:

Job Responsibilities:

Act as the primary point of contact for B2B clients regarding medical operations ensuring timely support and resolution of medical-related inquiries.

Manage approval issues and resolve them in line with medical guidelines and policy schedules.

Submit reimbursement requests and assist members in tracking and following up on their cases.

Perform portfolio analysis assessment and analysis for consumption reports.

Communicate and coordinate with external partners including insurance companies and Third-Party Administrators (TPAs) to facilitate approvals resolve issues and ensure smooth case handling.

Handle escalations professionally and proactively recommend solutions to improve the client experience.

Qualifications:

Bachelors degree in Healthcare Management Pharmacy Medicine Business Administration or a related field.

13 years of experience in medical operations insurance healthcare administration or related functions.

Strong knowledge of medical guidelines approval processes and reimbursement procedures.

Experience in liaising with insurance companies TPAs and other external medical/healthcare partners.

Excellent analytical skills with the ability to conduct portfolio assessments and prepare detailed consumption reports.

Strong communication and interpersonal skills for managing B2B client relationships and handling escalations.

High level of organizational skills and attention to detail to manage multiple cases simultaneously.

Problem-solving mindset with the ability to recommend process improvements.

Proficiency in MS Office (Excel PowerPoint Word); experience with medical/insurance systems is an advantage.

• Attractive bonus scheme based on performance.
  
• Working with ownership & growth Youll have real responsibility the space to take initiative and support to grow your skills.
  
• An energetic supportive team and a growing brand that values your voice.
  
• Eligibility to work in hybrid model.