YOUR JOB
You will oversee the systematic organization and accurate processing of incoming and outgoing electronic documents, faxes, claims, and related materials. Your responsibilities will encompass efficiently managing workflows, ensuring timely handling of documentation, and maintaining meticulous records of all transactions.
Responsible for logging and maintaining records of claims in the Intake system and processing platforms.
We conduct thorough reviews and evaluations of claims to determine eligibility for payment, ensuring accuracy and compliance with established guidelines throughout the process.
Responsible for organizing and categorizing data within our Claims Smart Indexing System, ensuring efficient file management and accurate classification.
The processing of received claims involves electronically transferring them across multiple platforms and Business Operating Branches (Bobs).
Responsible for managing and prioritizing incoming provider claims, inquiries, and GOP requests within the Salesforce platform.
Indexing and processing Intake provider claims, along with performing other departmental tasks, within the specified turnaround times (TAT’s), ensuring accuracy and efficiency in all operations.
Overseeing the diverse channels utilized for claims submission presents a key responsibility of this role.
Assistance with additional duties as assigned by management may also be required.
YOUR PROFILE
You possess advanced proficiency in both spoken and written English.
You demonstrate a high degree of accuracy and meticulous attention to detail.
Each day, you will collaborate with a variety of systems and applications to fulfill your responsibilities effectively.
You demonstrate strong organizational capabilities and outstanding proficiency in managing time effectively.
Maintaining the highest level of confidentiality when handling sensitive information is essential.
You possess strong proficiency in managing extensive volumes of electronic documents with precision and efficiency.
You excel in dynamic settings and adeptly manage competing priorities while maintaining focus on key responsibilities.
You demonstrate a positive outlook and the capacity to recover quickly from challenges.
A collaborative professional, you excel in working effectively both within your own team and across various departments, fostering strong partnerships and seamless cooperation.
You have earned a Diploma or Degree from an accredited institution.
Qualifications
BA/BSc/HND , Diploma
