Officer MCC

• Evaluates medical claims from the technical and medical perspectives as per policy terms and conditions.
• Channels claims officers in handling difficult medical cases and optimize the quality and quantity output.
• Checks particular treatment plan is necessary for the patient.
• Refers for a second opinion for cases where there is doubt in treatment plan.
• Provides clients an understanding of any declined medical claims.
• Maintains daily productivity targets and service levels.
• Manages routine daily claims administration work.
• Coordinates work flow & meet deadlines.
  

Behavioral Requirements

• Strong verbal and written communication skills.
• Show flexibility, excellent interpersonal skills.
• Team Player.
• Attention to detail and quality.
• Ability to work well with all levels of internal management and staff, as well as outside clients and users.
• Ability to train other staff.
• The ability to communicate sensitively and effectively with claims department and other departments having regard for the strict need for confidentiality.
• Experience of working with senior managers and understanding the necessity to act in a pleasant and courteous manner and to be able to work effectively with others.