Officer - Claims

Applying Claims Department Policy, Procedures and quality measures for processing claims.

• Processing Claims efficiently & accurately, according to FIFO (First In First Out) of providers network claims along with international claims through network providers.

• Conduct Medical Audit and review sample of Processed Claims – sample defined as per confidence level target set on a yearly basis - against scope of coverage and provider contracts as set in Claims Best Practice Manual.

• Checking batch list for printed out bordereau when required ahead of bordereau issuance.

• Submitting reports that reflects Health Care Provider Performance for unusual Behavior & trend upon observation.

• Number of processed invoices on a daily basis, should be achieved based on TAT Objective (Avg. Productivity required Vs TAT objective) that is communicated and set on a yearly basis by direct superior/ head of department.

• Quality of correspondence with internal clients through e-mails/mails/phone is very high, 100% of accuracy of information provided; the information provided is 100% relevant.

• Entering data accurately in order to provide accurate records to the company and Participated Insurance Companies (PICs).

• Work in high speed and efficiency to achieve monthly targets.