Job Purpose:
The Medical Insurance Complaints Supervisor is responsible for receiving, investigating, and resolving complaints related to medical insurance products and services. This role ensures all complaints are handled professionally and in compliance with regulatory requirements and company policies. The officer will also collaborate with internal departments to identify and address root causes of recurring issues.
Responsibilities:
- Receive, document, and track medical insurance complaints from customers.
- Investigate complaints thoroughly and ensure timely resolution in line with company policies and regulatory guidelines.
- Communicate effectively with customers to acknowledge complaints and provide updates throughout the resolution process.
- Ensure a professional and empathetic approach to handling sensitive customer concerns.
- Ensure all complaints are resolved in accordance with Saudi Central Bank (SAMA) regulations and other applicable laws.
- Maintain accurate and complete documentation of complaints and resolutions for regulatory reporting.
- Analyse recurring complaints to identify trends and root causes.
- Provide feedback and recommendations to relevant departments to improve processes and reduce future complaints.
- Collaboration & Reporting:
- Work closely with the Claims, Underwriting, and Customer Service teams to resolve complaints efficiently.
- Prepare regular reports on complaints, resolutions, and trends for management review.
- Qualifications, Experience & Skills:
- Bachelor’s degree in business administration, Healthcare Management, or a related field.
- Certification in Customer Service, Complaint Management, or relevant insurance certifications is a plus.
- 3-5 years of experience in complaints handling, preferably in the medical insurance industry.
- Knowledge of medical insurance products, claims processes, and relevant regulations.
- Familiarity with SAMA regulations and Saudi insurance industry standards.
- Strong problem-solving and analytical skills.
- Excellent communication and interpersonal skills.
- Proficiency in Microsoft Office (Excel, Word, PowerPoint)
- High attention to detail and ability to work under pressure.
