Job Description*
Responsible for organizing and processing the flow of incoming and outgoing documents (paper & electronic) in a back-office environment. The candidate ensures there is consistency in timely delivery of quality and quantity to meet set parameters measures to meet Service Level Agreements
Responsibilities
Receiving and documenting claims both electronic and paper claims
Sorting, processing, and vetting of claims firsthand for claims payment and ensuring they are accurately assigned.
File management and classification of data and supporting reporting compilation.
Electronic transfer of received claims to the various platforms.
Managing the flow between members and provider claims
Processing member and provider claims within stipulated Turn Around Times
Managing the different channels through which claims are received.
Cross referencing of emails received from members and providers for further processing.
Any other tasks as allocated.
Requirements*:
Active language knowledge of at least English (additional languages are a plus)
Executes assignments accurately and pays attention to detail.
Ability to plan and organise tasks independently.
Excellent time management skills with ability to continuously prioritize set tasks accordingly.
Upholds utmost discretion when handling confidential information.
Ability to handle large quantities of paper and electronic documents.
Works to deliver consistently even under pressure.
Self-Driven and can work with little or no supervision.
Ability to work collaboratively within a team.
Proficient in the use of Spreadsheets, word-processing and associated office IT Skills with CRM systems (e.g.) Salesforce with accurate data inputting.
Accountability – assumes ownership for achieving personal results.
Customer focused while executing mundane tasks.
Copes well in a changing environment
Education*: new Diploma and Bachelors degree (Any) – medical, Paramedical, Commerce, Statistics, Mathematics, Economics or Science, guided by job market
Experience Range*: Role open to new or early career Diploma and Bachelors Degree, guided by job market
Foundational Skills* –
Routine Operations Tasks execution
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