Job Description
Job Duties/ Responsibilities/ Accountabilities:
- Coordination of the medical claims.
- Receipt and registration of Provider claims.
- Keying-in of Provider claims.
- Adjudication of claims.
- Processing of claims within contractual timelines.
- Management of medical expenses within benefits.
- Preparation and collation of Provider claims, sending reviews and reports.
- Attendance of internal meetings to enhance productivity and profitability.
- Ensure all administrative reports are sent within allotted timelines.
- Unit document filling and record keeping.
- Escalation of unit requirements to other relevant internal stakeholders.
- Vetting of member reimbursement documents in accordance with incidental circumstances and agreed rates.
- Any other task and duty as assigned by the head of unit.
Requirement
- Education Qualification: Registered Nurse(preferably) or BSC (with industry experience)
- Data Analytics tools certification
- Experience (Dimension and No of years): Minimum of one year in similar role
Functional/ Technical:
- Good clinical skills
- Apt administrative skills
- Proficient in Microsoft office tools
Managerial:
- Ability to multi-task
- Problem solving
- Analytical expertise
- Discrete
- Behavioral:
- Conscientiousness
- Excellent Communication skills
- Time management skills
- Organizational skills
- Interpersonal skills