The Medical Claims - Officer will provide quality service to clients, promptly and effectively assesses and process 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.
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.