• Ensure high customer satisfaction in line with BUPA values and business strategy
• Ensure all cases adjudicated by the team is based on common medical practice and aligned with BUPA protocols and policy .
• Liaise with medical and non-medical staff at providers to ensure quality healthcare service for our members
• Maintain and update a database for the treating doctor and provider/hospital service delivery review of the customer experience based on clearly defined matrix and service levels
• Ensure compliance to SAMA and CCHI regulations during medical adjudication.
• Ensure achiving the daily Targets in term of productivity and speed answer for adjudicated requests
• Ensure proper interpretition and usage of clinical skills