Assistant (Insurance)

仕事内容

OBJECTIVES OF THE PROGRAMMEThe Department of Finance ensures that the financial management framework provides the required financial controls, reporting systems and procedures to meet the Organization’s needs. It is therefore responsible for WHO’s accounting policy and systems, corporate accounting, financial reporting, income and expenditure, donor accounting and reporting and treasury management policies. The Department of Finance has also the responsibility for insurance and pension services including administration of operations and risk management relating to staff and other financial risks.Description Of DutiesUnder the general supervision of Administrative Officer, SHI the incumbent is assigned to the receipt and processing of health insurance claims, including those involving the direct payment to physicians, hospitals and others on behalf of claimants. The incumbent also assists in analysing the accounts of the Staff Health Insurance, preparing reports, graphs, etc.A: Medical Claims (75%):

• Examining medical claims submitted by active and retired staff or their survivors in accordance with the rules of the Staff Health Insurance and the interpretation made by the Headquarters Surveillance Committee, in particular: ensures that proof of payment is provided in support of claims for reimbursement, verifies bank accounts and postal addresses; ensures that bills are submitted within established time limits; verifies accuracy of the amounts claimed; for each prescription of drugs, ensures that the medicaments prescribed are reimbursable in terms of the rules and established guidelines; verities the presence of a physician’s prescription in respect of special forms of treatment; in the case of hospitalization, checks whether the daily rates charged are within established limits and adjusts the claim as appropriate; ensures that sufficient information is provided to permit a meaningful analysis of the claims. If in doubt as to whether the claim qualifies for reimbursement, requests a medical report to be sent to the Medical Adviser; verifies entitlement to coverage.
• Prepares input documents for the processing of claims by computer
• Enters and validates daily claims on computer
• Contacts and/or prepares correspondence to medical providers, i.e. physicians, dentists, clinics, laboratories, etc. concerning medical claims/payment requests
• Receives active and retired staff to provide information on claims
• Validates claims pre-coded by regions and processes payment.
• Back-up to persons doing direct payments

B. Financial Accounting/Analysis (15%):

• Prepares financial reports and statements
• Compiles and assists in analysing statistics using graphs to illustrate trends, etc.

C. SHI Payment 5%:

• Back up for the SHI person(s) responsible for the tri-monthly payment (value US$ 2 m approx..) - verifies the exchange rate in the HIIS database corresponds to the official UN rate for the month. Ensures that all RO data has been received and processed by the team. Distributes a list of special “approvals” to the team, ensures that they are verified and approved by the supervisor. Reviews the different error reports - invalid/erroneous/not yet validated claims, mock payment and ensures that the team members take corrective action and ensures that all requests for reimbursement are in the system ready for payment. Reviews the high cost requests, checks and verifies with the team and has approved by the supervisor. Initiates the payment process in the database (no. voucher, batches, dates) and begins to make the calculations of the payments. Checks all of the accounts for the payment and reconciles any errors by making manual payment vouchers. Once all is reconciled and the claims are ready for payment , requests signature of supervisor and sends electronically to GSD. Prints all payment advices for HQ and Regions and ensures that they are placed in envelopes and dispatched appropriately.

D. Other (5%) - other duties as required.Required QualificationsEducationEssentialCompletion of secondary school education or equivalent.DesirableHigher education an advantage.ExperienceEssential:A minimum of 8 years administrative experience.Desirable

• Experience in health care insurance related activity, preferably involving a multicountry network would be an asset.
• In-depth knowledge of: SHI rules, staff rules, financial regulations of WHO, Swiss and French Medical Procedure/supply codes.

Skills

• The incumbent controls an ever increasing workload by revising priorities often on a daily basis and often several times a day.
• The incumbent uses mature judgement when responding to unusual requests, courtesy when redirecting callers and diplomacy when dealing with sensitive claims and drawing attention to staff on specific insurance rules.
• Incumbent ensures cases of potential fraud, excessive billing or other anomalies are dealt with under supervision and in absolute confidentiality.

WHO Competencies

• Knowing and managing yourself
• Producing results
• Communication

Use of Language SkillsEssential

• Expert knowledge of English.
• Expert knowledge of French.

DesirableExpert knowledge of WHO official language.REMUNERATIONWHO offers staff in the General Services category an attractive remuneration package, which for the above position includes an annual net base salary starting at CHF 82,568 (subject to mandatory deductions for pension contributions and health insurance, as applicable) and 30 days of annual leave.Additional Information

• This vacancy notice may be used to fill other similar positions at the same grade level
• Only candidates under serious consideration will be contacted.
• A written test may be used as a form of screening.
• In the event that your candidature is retained for an interview, you will be required to provide, in advance, a scanned copy of the degree(s)/diploma(s)/certificate(s) required for this position. WHO only considers higher educational qualifications obtained from an institution accredited/recognized in the World Higher Education Database (WHED), a list updated by the International Association of Universities (IAU)/United Nations Educational, Scientific and Cultural Organization (UNESCO). The list can be accessed through the link: http://www.whed.net/. Some professional certificates may not appear in the WHED and will require individual review.
• Any appointment/extension of appointment is subject to WHO Staff Regulations, Staff Rules and Manual.
• For information on WHO’s operations please visit: http://www.who.int.
• WHO is committed to workforce diversity.
• WHO prides itself on a workforce that adheres to the highest ethical and professional standards and that is committed to put the WHO Values Charter into practice.
• WHO has zero tolerance towards sexual exploitation and abuse (SEA), sexual harassment and other types of abusive conduct (i.e., discrimination, abuse of authority and harassment). All members of the WHO workforce have a role to play in promoting a safe and respectful workplace and should report to WHO any actual or suspected cases of SEA, sexual harassment and other types of abusive conduct. To ensure that individuals with a substantiated history of SEA, sexual harassment or other types of abusive conduct are not hired by the Organization, WHO will conduct a background verification of final candidates.
• WHO has a smoke-free environment and does not recruit smokers or users of any form of tobacco.
• This post is subject to local recruitment and will be filled by persons recruited in the local commuting area of the duty station.

GradeG6Contractual ArrangementFixed-term appointmentContract Duration (Years, Months, Days)Fixed termJob PostingOct 3, 2022, 2:03:59 AMClosing DateOct 24, 2022, 4:59:00 PMPrimary LocationSwitzerland-GenevaOrganizationHQ/SHI Staff Health Insurance FNM BOSScheduleFull-timeIMPORTANT NOTICE:Please note that the deadline for receipt of applications indicated above reflects your personal device’s system settings.