Claims Integration (pipeline)
???, S02, SA, Saudi Arabia
Job Description
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Processing provider claims and applies regulator KPI in addition to execute key projects that supports the claims efficiency and other key business priorities.
Claims efficiency & Provider process:
Received and validate providers submission through NPHIES within KPI. Received and validate providers documents such as invoices, approvals, and all related support documents. Give orientation to providers for claims guide. Communication with the providers and follow up in any requests, rejection and inquiries Ensure adherence to legal and company policies and procedures
Reporting:
Collect and analyse data received from providers. Create and maintain report and dashboards to track key performance. Develop and implement data quality checks to ensure accuracy and consistency of data
Project Support:
Support in planning projects and provide materials and tools to help excute NPHIES projects Ensure post-implementation benefits realization are reported accurately and on timely manner
Hotline & Resolve PR Complaints:
Handle calls from providers, provide solutions related to claims submission and check the dashboard to evaluate the total calls Resolve PR escalated cases in timely manner
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Skills
Bachelor's degree Business Administration or relative majors. Experience in health insurance field Proficiency in English and Arabic (spoken and written) Microsoft Office skills Communication skills * Interpersonal skills
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Job Detail
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Job IdJD2245025
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IndustryNot mentioned
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Total Positions1
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Job Type:Full Time
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Salary:Not mentioned
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Employment StatusPermanent
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Job Location???, S02, SA, Saudi Arabia
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EducationNot mentioned