claims operations

Overview

Who you'll be working for

What requirements you'll need to be eligible

• With 1 - 3 years of experience in medical claims handling
   
• With healthcare background is preferred
   
• With knowledge of medical terminology, billing codes (ICD 9, ICD 10, CPT) and medical insurance polices is preferred
   
• Strong team player, willing to learn, able to work independently and effectively under pressure

What you'll be doing on the job

• Assess medical claims in compliance with the terms and conditions of the policy
   
• Verify medical codes, diagnosis and procedure to ensure compliance with industry standards (e.g. ICD 9, ICD 10, CPT)
   
• Escalate enquiries and complex cases to Senior when necessary in line with internal guidelines
   
• Process claims payment in accordance with the company's objectives and guideline
   
• Prepare claim communication letter

Consultant Contact