Claims Management Processor

• Ensures that insurance claims information is entered into the system correctly
• Ensures that provider’s fees and service items charges coincide with their existing contract price list with NextCare
• Ensures the accuracy of the entered data as per the existing standard steps and procedures of direct claims processing
• Compares data on claims applications
• Screens claim documents and process claim adjustment
• Ensures Payment Orders are properly created and forwarded accordingly for final documentation and filing
• Ensures adaptability in various work-related tasks to be able to facilitate a multi-tasking role
• Ensures that high quality standard of work performance is achieved at all times
• Stands as a reference person for information on inquiries concerning claims processing procedures
• Monitors correct application of beneficiary share accordingly on service items billed
• Makes sure that claims are properly audited of all data entered with accurate medical claims details
• Notes all discrepancies during the course of the system process are properly forwards and notifies to immediate supervisors
• Provide requisition of office supplies for Individual and Team requirement
• Researches claims as needed
• Obtains and audit medical records to compute and record patient charges
• Performs other related duties incidental to the work described herein

• Bachelor’s Degree
• Paramedical background preferred
• 2+ years filing/documentation experience
• Experience within the Health Care Industry, TPA’s, insurance companies, Hospitals, Medical Centers is a plus
• Physically fit to carry out duties
• Sound knowledge of Project Management principles and tools
• Accurately forecasts revenue, profitability, margins, bill rates and utilization
• Legally permitted to work in the country of operations
• Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills

Experience within the Health Care Industry, TPA’s, insurance companies, Hospitals, Medical Centers is a plus

• Large variety of courses and targeted development programs
• International mobility and career progression are encouraged
• Work Well programs for health and wellbeing
• Flexibility in planning and arranging for a better work-life balance