Summary Claims officer will provide quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards. Primary Responsibilities • Manage routine daily claims administration work. • Coordinate work flow & meet deadlines. • Evaluating claims with regards to eligibility. • Decision on high cost and complicated cases. • Preauthorization. • Attending calls and e-mails from insurance companies, clients, and providers. • Coordinating with providers for direct billing. • Making suggestions to improve service. • Increasing efficiency, minimizing errors and administration time. Communication Will be reporting to the Claims manager; however, will support other team members. Knowledge and Skill Requirements • Requires strong computer skills. • Strong verbal and written communication skills. • Show flexibility, excellent interpersonal skills. • Team Player • Attention to detail and quality • Ability to work well with all levels of internal management and staff, as well as outside clients and users Minimum Requirements • Bachelor’s of Medicine required ( preferably MBBS) • Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus) • The ability to communicate sensitively and effectively with claims department and other departments having regard for the strict need for confidentiality. • Advanced knowledge of Microsoft packages (Word, PowerPoint, and Excel) e-mail, electronic calendar and Internet. • Knowledge of overall insurance industry practices is a plus; the ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines. • Experience of working with senior managers and understanding the necessity to act in a pleasant and courteous manner and to be able to work effectively with others. • To be capable of responding diplomatically to pressures and problems showing a calm approach to working towards deadlines and always able to show an innovative and creative approach to work. • Physically fit to carry out duties and responsibilities. Other Key Success Factors: • TATSH System Training for one month. • Customer Services experience Working Conditions Working conditions are normal for an office environment. Please send your C.V to [email protected] , writing in the subject line Claims Officer C006
Posted on: Thu, 17 Jul 2014 07:43:50 +0000
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