Reimbursement claims, Pre-authorization, Direct Billing claims
Posted on :
21-06-2025
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1 Vacancy
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Job Description
- University Degree or Diploma in Nursing / Medical or medical practitioner.
- Min 4 8 years of experience (preferably relevant experience).
- Local candidates with valid QID preferred.
- Sound medical knowledge and willing to work in non-clinic process.
- Minimum of 1 year experience in handling authorization.
- Should be willing to work in shifts as the department works on 24/7 function.
- To manage and process claims ensuring documentation verifying eligibility obtaining necessary pre-authorization and facilitate billing for the reimbursement process.
- Provide accurate and timely medical claims handling services in accordance with company policies procedures and standards.
- Assess evaluate and process claims in an effective and efficient manner to support the smooth operation of the Claims function.
- Maintain detailed and accurate records of all claims assessments and decisions.
- Liaise with internal departments and external medical providers to gather necessary information for claim adjudication.
- Ensure compliance with regulatory requirements company guidelines and service level agreements (SLAs).
- Contribute to the continuous improvement of claims processes and systems.
- Be flexible in working across different types of Claims functions as assigned by management.
Employment Type
Full Time
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