Job Description: 1. PHONE CALLS
a. Handle phone calls from clients, specifically addressing routine concerns such as, but not limited to, provider
accreditation, doctor availability, reimbursement updates, LOA issuance, and assistance during ailment, among
others.
b. Coordinate with the Front-End Team for meeting-related concerns to ensure a seamless transition of calls when
necessary.
c. Collaborate with other departments, to resolve client concerns efficiently and effectively.
d. Provide guidelines and procedures to troubleshoot and resolve common issues or escalate complex problems to
higher-level support if required.
2. EMAIL MANAGEMENT
? Centralized Email Repository: The Back End Team has the primary responsibility for managing and
responding to client emails in the centralized repository.
? Email Handling Guidelines:
a. Respond to client emails promptly.
b. Provide accurate and comprehensive information in responses, addressing client concerns and inquiries
thoroughly.
c. Collaborate with other departments, when necessary, to obtain the required information for responding to
complex client inquiries.
d. Maintain a record of all client email interactions, including the details of the concern, actions taken, and any
follow-up required.
3. MAF (Coordination with Front End Team) :
a. The Back End Team will coordinate with the Front-End Team to obtain the signed contract and Renewal List for a
renewed account.
b. Based on the obtained information, the Back End Team will encode the Master Application Form (MAF)
c. Will incorporate any necessary revisions or adjustments advised by the Actuarial Team.
d. The Back End Team will initiate the request for the issuance of the Certificate of Coverage (COC) based on the
uploaded MAF.
e. Upon receiving the COC, the Back End Team will promptly email it to the client.
4. AMLA REQUIREMENTS ? Account Identification and Initial Follow-Up:
a. The Back End Team will identify accounts that require follow-up for Anti-Money Laundering Act (AMLA)
requirements.
b. Initiate the initial follow-up by contacting the client through email or phone to request the necessary AMLA
documents and information.
c. Provide clear instructions to the client regarding the specific AMLA requirements and the preferred method of
submission.
? Document Tracking and Reminder System:
a. Maintain a tracking system to monitor the status of AMLA requirements for each account.
b. Set up a reminder system or calendar alerts to ensure timely follow-up on pending or overdue AMLA
documents.
c. Weekly update the tracking system with the latest status and any communication or action taken.
? Follow-Up Communication:
a. Conduct a monthly follow-up communication with the client to remind them of any outstanding AMLA
requirements.
b. Utilize email, phone calls, or other appropriate means of communication to ensure the client is aware of the
importance of complying with AMLA regulations.
5. MEMORANDUM OF AGREEMENT
a. Once AMLA requirements are completed, generate the Memorandum of Agreement (MOA) document.
b. Collaborate with the legal and compliance teams to address any necessary contract modifications or
negotiations.
c. Coordinate the contract signing process with clients, ensuring all required signatures are obtained.
d. Track contracts that require notarization and ensure the notarization process is completed.
e. Maintain an organized contract database to track the status and details of each contract.
f. Submit the notarized hard copy of the contract to the client and another copy to the Audit Team along with a
receiving copy for proper documentation.
g. The back-end team will have the responsibility of creating and sending the Memorandum of Agreement (MOA)
for renewed individual accounts.
6. REIMBURSEMENT MONITORING ? Soft Copy Reimbursement:
a. Retrieve and organize all soft copy reimbursement requests from the repository email
b. Conduct an initial review to ensure completeness and accuracy before encoding in the portal.
c. Coordinate with the claims team to ensure timely processing and resolution of reimbursement requests.
? Communication and Follow-Up:
a. Follow up with the claims team to ensure timely processing and resolution of reimbursement requests.
b. Respond promptly to client inquiries and provide updates on the status of their reimbursement requests.
c. Send a copy of the deposit slip to the client via email
7. SMARTSHEET MONITORING ? Familiarize Yourself with SMARTSHEET:
a. Gain a thorough understanding of SMARTSHEET, the tool used to track and monitor client concerns.
b. Review the various sheets, columns, and entries within SMARTSHEET to understand the information and
concerns captured.
? Regularly Check SMARTSHEET:
a. Routinely log in to SMARTSHEET and review the incoming client concerns.
b. Monitor the assigned sheets and columns related to client concerns.
? Follow-Up and Escalation:
a. Monitor the progress of each assigned concern in SMARTSHEET.
b. Follow up with the respective department to ensure timely and appropriate action is being taken.
c. Escalate unresolved concerns to higher-level management or supervisors, as necessary. provide visibility into the
client retention management process.
Job Qualifications : Educational attainment: Bachelor's degree in business, marketing, sales, or a related fieldYears of relevant experience: at least 1-year administrative workArea/s of experience: HMO but not requiredKnowledge: Proficiency in using office software (Microsoft Office)Skills: Organizational Skills