Description

Job Description

The Medical Claims – Assessor will provide quality service to clients by promptly and effectively assessing and processing claims and approval according to operations set standards.

Main Tasks

• Manages routine daily claims administration work.
• Coordinates work flow & meet deadlines.
• Evaluates claims with regards to eligibility.
• International Preauthorization.
• Attends calls and e-mails from insurance companies, clients, and providers.
• Makes suggestions to improve service.
• Increases efficiency, minimizes errors, and administration time.
• Coordinates with different departments within the company.
• Reports errors when detected.
  

Behavioral Requirements

• Strong verbal and written communication skills. Must have the ability to communicate sensitively and effectively with claims department and other departments having regards for the strict need for confidentiality.
• Show flexibility, excellent interpersonal skills.
• Team Player.
• Knowledge of overall insurance industry practices is a plus; the ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines.
• 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.
• 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 approach to work.
• Ability to work well with all levels of internal management and staff, as well as outside clients and users.
• Flexible and ability to work shift .
  

Behavioral Competency

Customer & Market Excellence:

• Strive for excellence at every touch point with the customer
• Foster state-of-art technical/operational knowledge and strive for continuous simplification
• Be the benchmark
  

Collaborative Leadership:

• Empower the team and provide purpose and direction
• Develop people, provide feedback and care to employee wellbeing
• Collaborate and exchange best practice.
  

Entrepreneurship:

• Act on opportunities, anticipate trends, take risk, and promote a culture that allows for honest failure
• Take ownership and responsibility
• Embrace innovation and a culture that allows to make decisions without fear of retribution.
  

Trust:

• Act with integrity, honor commitments, tell the truth
• Foster diversity and inclusiveness
  

Act transparently and promote corporate social responsibility.

Minimum Requirements

• Bachelor’s degree (Nursing): with at least 2 years of clinical experience.
• 3+ years claims processing experience in an Insurance / TPA environment,
• It is a Must to have coding experience.
• Physically fit to carry out duties.
• Legally permitted to work in the country of operations.
• Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.
  

Minimum Requirements

• Bachelor’s degree (Nursing): with at least 2 years of clinical experience.
• 3+ years claims processing experience in an Insurance / TPA environment, A Must to have coding Expierence.
• Physically fit to carry out duties.
• Legally permitted to work in the country of operations.
• Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.