About the job
A financial holding company, Chedid Capital is a leading investment group in the insurance and reinsurance fields. The Group operates across Europe, the Middle East, Africa and South Asia. The Company plays a role in the forefront of the industry, being part of one of the top 20 Reinsurance Brokers in the world.
Chedid Capital is looking for a Senior Officer TPA Operations that will be responsible for evaluating and monitoring the health claims adjudication process to ensure compliance with group procedures, directives, and client agreements. The role involves assessing operational performance, supporting internal audits, and contributing to the development of procedure manuals. The Senior Officer plays a key role in upholding quality standards and driving continuous improvement across Ascoma’s TPA operations.
Joining our 1700 dynamic team members, spread among 64 subsidiaries worldwide, offers you endless growing opportunities.
Responsibilities
- Evaluate and analyze the health insurance claims adjudication process to ensure operations comply with procedure manuals, internal directives, SLAs, and other agreements signed with clients.
- Assess the proper application of operational procedures validated by the Group, as well as adherence to internal audit recommendations.
- Professionally document findings and observations.
- Monitor performance indicators established by the Group Health Department.
- Support performance oversight by applying procedures defined by the Health Department.
- Participate in the drafting of operational procedure manuals.
Requirements
- Minimum Bachelor’s degree in Nursing Sciences.
- At least 6 years of experience in health management (including system use, operational practices, and teamwork).
- Clinical experience is preferred.
- Fluency in French and English is a must.
- Willingness to travel to Africa regularly.
- Strong knowledge of Microsoft tools (Word, Excel, PowerPoint, etc.).