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The Medical Claims Officer will provide quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards.
Job Responsibility:
Manages routine daily claims administration work
Coordinates work flow & meet deadlines
Evaluates claims with regards to eligibility
Takes decisions on high cost and complicated cases based on standard operating procedures
Handles International Preauthorization cases as required
Attends calls and e-mails from insurance companies, clients, and providers
Coordinates with international providers for direct billing
Makes suggestions to improve service
Increases efficiency, minimizes errors and administration time
Requirements:
Bachelor’s of Medicine (MBBS) only
Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus)
Physically fit to carry out duties
Legally permitted to work in the country of operations
Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills
Nice to have:
Organizational & time management skills
Excellent team player
Ability to work well with all levels of internal management and staff, as well as outside clients and users
Ability to demonstrate sound work ethics
Show flexibility with excellent interpersonal skills
The ability to communicate sensitively and effectively with claims department and other departments having regard for the strict need for confidentiality
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
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
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