Job Description (JD)
| Nama Program | Pentadbiran Tuntutan Insurans Takaful/Nyawa Keluarga [K651-001-4:2017] |
|---|---|
| Kod CU | K651-001-4:2017-C04 |
| Competency | Core |
| Tajuk CU | HOSPITALISATION AND SURGICAL TAKAFUL/ INSURANCE CLAIMS ON GUARANTEE LETTER ARRANGEMENT |
| Penerangan CU | Hospitalisation and Surgical Takaful/ Insurance on Guarantee Letter Arrangement refers to the handling of policy that covers medical expenses for sicknesses or accidents that result in the need for medical care surgical expenses as well as cost of hospitalisation based on guarantee letter arrangement. The package benefits are ranges and different from one company to another. The person who is competent in Hospitalisation & Surgical Takaful/ Insurance Claims on Guarantee Letter Arrangement shall be able to arrange for patient admission to hospital, review additional request to increase limit of guarantee amount from TPA/ Health Care Provider, arrange patient discharge from hospital and process payment for TPA/ hospital within the timeframe based on the certificate/ policy and SLA in accordance with company’s guidelines and regulatory bodies’ requirements. The outcome of this competency is to conclude, finalise and disburse the claims to the claimants within the timeframe based on the certificate/policy and SLA in accordance with company’s guidelines and regulatory bodies’ requirements. |
| Tempoh Latihan | 160 |
| Objektif Pembelajaran | The outcome of this competency is to conclude, finalise and disburse the claims to the claimants within the timeframe based on the certificate/policy and Service Level Agreement (SLA) in accordance with company’s guidelines and regulatory bodies’ requirements. Upon completion of this competency unit, trainees will be able to: 1. Arrange for patient admission to hospital 2. Review additional request to increase limit of guarantee amount from TPA/ Health Care Provide 3. Arrange patient discharge from hospital 4. Process payment for TPA/ hospital |
| Pra-Syarat | Completed CU 01: Family Takaful/ Life Insurance Claims Intimation and VerificationCompleted CU 02: Family Takaful/ Life Insurance Claims AssessmentCompleted CU 03: Family Takaful/ Life Insurance Claims Disbursement and Repudiation |