Opportunity Description
About The Role
Process authorized inpatient & outpatient claims transactions within the required benchmarks.
- Process all Inpatient, Outpatient claims and pre-approval requests received as per stipulated requirements
- Ensure meeting individual quality, turn around time and productivity benchmark
- Review/approve cases that exceeds subordinates’ authority
- Respond to email enquiries from internal and external parties
- Perform outbound call to customers when required
- Training of new joiners on claims processing rules and products knowledge including Review and Feedback for On-The-Job training cases
- Providing training in System Navigation and Processing Steps, towards certification with Claims Approval Authority, as stipulated in the Claims Approval Authority guidelines.
- Conduct regular claims review in claims performance to ensure claims principles/authorities are adhered to. Review claims decis...
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