Medical Claims Officer

• 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.
  

Behavioral Requirements

• 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