Health Insurance Claims Team Leader

Laferla Insurance Agency Ltd. in Malta is currently looking to recruit a Health Insurance Claims Team Leader to join their team on a full-time basis.

OVERVIEW:
The Health Insurance Claims Team Leader is a natural leader who resonates with the company’s core values – Family, Loyalty, Credibility, Stability and Quality – and integrates these values into their daily work.

KEY DUTIES AND RESPONSIBILITIES:

• Leading the Health Insurance Claims function, including assessing and paying claims directly to customers or service providers, as well as overseeing the same activities within the team, ensuring that claims are processed accurately and efficiently, meeting both customer expectations and company objectives and guidelines
• Acting as a primary point of contact for health claims-related communication with internal and external stakeholders, including responsibility for handling emergency medical pre-authorisation cases which may happen outside of office hours
• Operational team leadership duties including leave management; managing team tasks, responsibilities and relationships including maintaining a positive team spirit; monitoring KPIs and objectives including efficiency, customer experience and technical objectives as agreed with management
• Acting as a liaison for the company with the health claims team, with a responsibility to implement and maintain the execution of the company’s objectives & strategies, vision, core values, tone of voice & image within the team
• Identifying needs for hiring, training, and developing staff to ensure a high-performing and professional team
• Ensuring that the health claims department maintains excellent customer service levels, settling claims, answering queries, and resolving complaints promptly and professionally
• Identifying potential risk areas within the claims and operational processes and working with management to develop strategies to mitigate these risks
• Analysing claims data to identify trends, prepare reports, and present such to management and the Board of Directors
• Keeping abreast with innovations and the evolving landscape within the health insurance industry both locally and internationally and presenting such to the Board accordingly.

SKILLS AND QUALIFICATIONS:

• A minimum of 2 years of experience in a similar role within a health insurance team
• Possess qualifications in insurance such as ACII or an equivalent bachelor’s degree in insurance, whilst qualifications in medicine or prior experience within the medical industry will also be considered a major asset
• Possess in-depth knowledge of health insurance claims processing
• Familiar with claims management software and other relevant IT systems to ensure efficient claims processing
• Be fluent in both English and Maltese, with other language skills being considered an asset
• Possess excellent verbal and written communication and interpersonal skills
• Possess strong customer service skills with the ability to handle inquiries and complaints from policyholders, ensuring their issues are resolved satisfactorily
• Be organised with a sharp eye for detail
• Be a team player
• Possess the ability to lead, mentor and motivate the team while ensuring that objectives and performance standards are met
• Capable of managing conflicts within the team and resolving issues promptly and effectively
• Proficient in identifying training needs within the team
• Be an efficient problem-solver
• Possess a thorough understanding of regulations and compliance requirements and keep up to date with changes in health insurance-related products, services, and processes to ensure the team and company adhere to the latest standards.