Provider Coordinator, East China
- To ensure all documents and contracts are up to date in the systems (i.e. Shared Folder and Shared Point) on a yearly basis
- To ensure the network list is updated monthly and shared with the concerned departments
- To update all providers on Facility Finder and SWAN
- To manage the reconciliation reports of the providers and liaising with the concerned internal departments and Network Consultants
- To provide and maintain ProviderWorld accounts for network providers and service partners.
- To co-ordinate all operational activities of service partners and ensure efficiency and delivery of auditable savings.
- To manage relationship with service partners in region and deliver effective cost containment solutions.
- To support the positioning of Bupa Global as the expert in the international healthcare arena.
Provider Contract Renewal and Maintenance
- Communicating renewal document details to contracting consultants.
- Linking duplicate providers in SWAN and maintaining department central provider record sheet.
- Update information and maintain records in SWAN, Shared Folder and Shared Point regarding contracted providers.
- Support on provider information on FF
- Updating the network list monthly to be shared with the concerned departments.
Claims and Payment Queries
- To investigate statements of out-standing accounts from participating providers with the concerned claims teams
- Investigate aged –debt queries
- Manage claim reconciliations in the region and share the investigated reports with clear explanation of Bupa Global Decisions with Contracting Managers for any negotiations taken forward with the provider
Provider World (on-line portal for providers and TPAs)
- Unlock ProviderWorld accounts and reset account information; delete users from PW where appropriate for network providers and service partners.
- Provide usage feedback/escalate issues to Relationship Owners.
- Communicate well in advance with all Service Partners and Providers of all site changes or enhancements.
- Drive high level of provider satisfaction by handling providers’ PW requirements proactively.
Service Partner Management:
- Proactively work with a portfolio of Bupa Global’s Service Partner (TPA) relationships (and their Providers) in the region to ensure delivery of effective operational processes to support cost containment activities
- Support the TPA Development & Contracting Managers in evaluating TPA performance (including monthly reports, quarterly reviews and quality audits)
- Coordinate and follow up on effective query resolution across a number of stakeholders including internal customers, brokers, TPAs and providers
- Work with the TPA Development & Contracting Managers to maintain effective working relationships with partners, providers and internal Bupa employees and departments to ensure delivery of TPA objectives.
- Conduct regular operational calls covering pre-authorisation, complex cases and claims administration
- Streamline processes to ensure operational efficiencies within BG and the TPAs
- Assist in developing the tools for maximising TPA efficiency, and avoiding duplication of tasks
- Produce regular activity reports in agreed formats
- Complete partner governance monthly reports
- Complete Quarterly reviews for service partners
- Work positively in association with colleagues especially in Healthcare Services, Claims and Bupa Global.
- Set expectations with providers on incoming queries on reconciliation and turnaround times.
The Ideal Candidate
Background in the global health insurance market, or relevant transferable skills and knowledge from other financial services industries such as Life Insurance, Retail, hospital or clinic, Commercial or Investment Banking and Wealth Management.
Previous experience of a complex and multi skilled customer facing roles within a contact centre setting
A track record of achieving and exceeding productivity and quality targets
Highly customer focussed
Excellent interpersonal, communication and influencing skills are required with emphasis on achieving results and successful outcomes.
Ability to speak English and Cantonese languages is a must. An ability to speak Mandarin would be an advantage.
About the Company
Bupa is a leading global health and care company, offering health insurance, medical subscription and other health and care funding products; we run care homes, retirement and care villages, primary care, diagnostic and wellness centres, hospitals and dental clinics. We also provide workplace health services, home healthcare, health assessments and long-term condition management services. Bupa has over 30M customers in 190 countries and employs close to 80,000 people, principally in the UK, Australia, Spain, Poland, New Zealand and Chile, as well as Saudi Arabia, Hong Kong, India, Thailand, and the USA
Bupa is a purposeful, commercial organisation. Bupa's purpose is: . It defines everything we do and is the reason we exist. With no shareholders our profits are reinvested to provide more and better healthcare fulfilling our purpose.
We have grown significantly, particularly over the past three years (2013, 2014 and 2015), when we accelerated execution of our Bupa 2020 strategic vision. We are targeting revenues in excess of £12Bn in 2015. Because Bupa does not have shareholders it does not have a listing, but if it did it would be in the FTSE 100. Bupa is not a mutual or a charity but a company limited by guarantee that seeks to maximise its profits in order to fulfil its purpose. With customers in virtually every country in the world and 70% of its revenues now generated outside the UK, Bupa is a truly international organisation
Bupa believes that the growth and performance of our leaders and our people is the single biggest pathway to fulfilling our purpose (longer, healthier, happier lives) and delivering Bupa’s 2020 goals. We have a leadership framework called “Bupa Leaders Are” which sets out what great leadership looks like at Bupa. Leaders are called upon to grow themselves, to grow others, to grow the business, to improve the health of the world. We are looking for individuals who are capable of delivering extraordinary business outcomes.
Bupa Global is the worldwide Bupa business. We provide international private medical insurance products and services for globally minded and mobile people who want the most premium coverage and access to the best healthcare anytime, anywhere in the world, whether at home or when studying, living, travelling or working abroad. We have over 1,700 employees working for our circa 2million customers around the world. We have a medical advice line staffed by a team of experienced, multi-lingual advisers to offer our customers support 24 hours a day, every day. We also have an emergency medical team of doctors on hand as an optional benefit to organise emergency assistance and evacuations.
Bupa Global has key regional offices in London, Brighton, Miami, Philadelphia, Copenhagen and Hong Kong as well as commercial operations in Egypt, Mexico, the Dominican Republic, Bolivia, Panama, Guatemala and Ecuador Bupa Global is currently organised around five regional hubs: Bupa Global Middle East, Bupa Global Greater China, Bupa Global Latin America, Bupa Global North America and Bupa Global Rest of World.