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Operational Risk Specialist
Operational Risk SpecialistNespresso Deutschland GmbH • Meycauayan, de
Operational Risk Specialist

Operational Risk Specialist

Nespresso Deutschland GmbH • Meycauayan, de
30+ days ago
Job description

Operational Risk Specialist

POSITION SUMMARY

Joining Nestlé means you are joining the largest food and beverage company in the world. At our very core, we are a human environment – passionate people driven by the purpose of enhancing the quality of life and contributing to a healthier future.

Our Team in Nestlé Business Services is in charge of delivering world class business support to our colleagues and clients in Nestlé globally. We are committed to deliver with passion, reliability, innovation, discipline and excellence. Are you ready to join us?

A day in the life of...

  • Prepare and analyze medical billing and support on completing the payments with Insurers on a timely manner
  • Conduct analysis on medical coding specifies in the documents to properly understand and have a thorough analysis to support medical insurance processes
  • Handle claims, follow-up and review to ensure proper documentation is in place. Attend to insurance queries.
  • Involvement on thorough check and consultation with Nestle doctors about the special case of medical claims.
  • Provide report related to utilization, claims trend or other ad hoc reports needed by the market wherein the source data is taken internally or from Insurer
  • Manage and validate census data and endorse any movement as endorsement based on the agreement on the policy
  • Ensure the maintenance of all necessary data, meet all internal and external reporting requirements. (medical data)
  • Addresses escalated Insurance issues and complaints from the Market and works with the GRS Team/Total Rewards in providing analysis and resolution.
  • Conducts regular calls, debriefs and workstream reviews with the markets and other departments, including identification of improvement opportunities and mitigation measures.

What will make you successful

Degree in Accounting, preferably a CPA, or Degree in Risk and Insurance Finance

At least 3 years of working experience in BPO/Shared Services setting and/or had experience working with foreign markets

Accounting and Actuarial mindset very useful in other activities (reconciliations / data analysis / simulations)

Knowledge in SAP and MS Applications (preferably proficient in excel)

Demonstrates the ability to positively influence and guide team members

Capable of delivering work independently with minimal supervision

Effectively manages and engages stakeholders

Proactively identifies, proposes, and implements process improvements

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Operational Risk Specialist • Meycauayan, de

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