Role & responsibilities

MOL and Live Chat Process

The process involves addressing end to end inquiries related to Members (Health insurance) pre-authorization, policy servicing, claim assessment, complaints, and any other policy and claims-related queries through Live chat or email. These professionals are required to have a complete understanding of all the products/services portfolio of the organization to aid in responding to queries. The representative will engage with members through the Email and live chat platform, providing timely and accurate responses to their inquiries while maintaining key performance indicators such as Chats per hour (CPH) to ensure effective handling of member interactions.
- Engage with members through live chat to address inquiries related to health insurance policies, such as pre-authorization, policy servicing, claim assessment, complaints, and other policy and claims-related queries while adhering to ASA targets.
- Need to a have deep understanding of health insurance policies, procedures,



and claim processing in order to provide accurate and timely assistance to members.
- Understanding of the life cycle of the AXA Health insurance claims life cycle from Policy Servicing, Underwriting, Pre-authorization, Assessment, Complaints. Provider sourcing etc.,
- Collaboration with internal teams will be essential to resolve complex member issues and will be expected to escalate cases when necessary to ensure timely resolution.
- Require accurately documenting member interactions and information for tracking and reporting purposes.
- Create a Complaint log where then member expresses dissatisfaction regarding the services
- Handle customer complaints, provide appropriate solutions and alternatives within the time limits; follow up to ensure resolution.
- Ensure compliance with company policies, procedures, and regulatory requirements while assisting members with their inquiries.
- Maintain a positive, empathetic and professional attitude

📌 Walk-in || Associate (Pune)
🏢 AXA Global Business Services
📍 Pune