Job Summary
Responsible for processing and ensuring medical claims are managed timely and in accordance with policy terms and conditions, and assist with financial counselling and other administration duties.
Role and Responsibilities
Business Office Management
- Responsible for following up on queries, and providing end-to-end support in processing medical claim submissions, regarding Mediclaim and Corporate Insurance claims, including reimbursements.
- Provide accurate adjudication of claims, pre-authorization and LOG issuance to meet operational targets.
- Collect accurate information and documents to proceed with the claim process
- Monitor and timely follow-up on the progress of pending claims to assist with quick resolutions and proper closure
- Liaise with doctors and clinics for facility bill size estimations
- Follow up with patients and insurers for outstanding hospital bills
- Support patients, clinics and front office in day-to-day insurance claims matters
- Check validity of claims prior to data entry into system and ensure mediclaims are filed within a strict timeline
- To handle enquiries from internal and external parties within the agreed targeted turnaround time
- Maintain accurate case records and all related communication
- Any other duties or projects as assigned
Qualifications and Education Requirements
- Diploma/degree and above with experience in Healthcare/Insurance/Third Party Administrators industries preferred.
- Meticulous and detail oriented at work with accuracy of data entries into system
- Able to work in a fast-paced environment and work independently
- Proactive, Problem solver, Good Team Player
- Willing to learn and adaptable to working environment with minimal supervision
- Proficient in Microsoft Office applications (Excel, Word and Power Point)
