Job Description
Job Purpose / Objective:
Responsible for all aspects of medical request approval, rejection and review claims on a daily basis to companies and insurance companies and monitors application data entry of company and insurance company policies
Key Responsibilities / Accountabilities:
- Responsible for checking and reviewing of claims for monthly claims submission.
- Reviews claims rejection.
- Prepares correspondence justifying rejected claims.
- Prepares medical report as per requested by the insurance companies.
- Coordinates with physicians regarding re-explanation on rejected claims.
- Check on daily/ weekly basis the Outcome of each Claim Processors, the perfection of the claim, the attachment, etc.
- Perform administrative tasks when required.
- Train and guide new staff.
- Participate in person-centered care initiatives undertaken by HMG.
- Enrich patient experience with compassion, respect and dignity.
- Perform other applicable tasks and duties assigned within the realm of his/her knowledge, skills and abilities.
Education/ Professional Qualification:
- Bachelor’s Degree Healthcare or insurance related
Experience:
- Minimum of two years’ experience in dealing with medical insurance
Professional Licensing / Certification / Training:
