Job Purpose:
To enhance customer satisfaction by reducing turnaround time in processing of medical claims and enhance cost effective care whilst provide quality care.
Key Responsibilities:
Vetting of claims to ensure only valid claims is settled.
Prompt data capture of both Inpatient and outpatient claims in the system.
Ensure reimbursements claims are posted within 14 days of receipt.
Respond to client queries on any issues raised within scope of the job.
Carry out verification of outpatient claims.
Ensure that the panel of doctors is strictly adhered to by clients and hospitals in order to reduce claims costs.
Assess medical claims documents for authenticity and process payments within set service level agreements.
Liaise with Accounts/disbursement to ensure safe and timely dispatch of reimbursement claims cheques to clients.
Maintain accurate records on medical claims.
Manning of the 24hr helpline.
Offer excellent customer service.
Assist with posting of outpatient claims.
Knowledge, experience and qualifications required
Qualifications, Knowledge, Experience:
Bachelor’s Degree.
Good analytical skills and report writing skills.
Computer literate.
2 years’ relevant experience.
Other desirable attributes:
Strong personality with interpersonal sensitivity.
Good written and verbal communication skills.
Proactive.
Team player.
Strong negotiating skills.
Assertive and confident.
Self-starter.
Creative & open-minded.
High level of numeracy and strong analytical skills.
Apply via :
britam.taleo.net
