Medical Claims Executive
Iris Health Services Llc
منذ 2 يوم
source : Monster

Job Description :

ï Evaluates and processes claims in accordance with insurance policy terms and conditions, company policies and procedures according to productivity and quality standards.

ï Ensures that targets are met for department Turnaround time, Quality and Productivity.

ï Identify and report back any type of claims observation or issues that may affect the process.

ï Collect and analyze claims data to identify and resolve errors, delayed claims, and processing issues. Providing recommendations to take steps to improve the claims processing quality standards and productivity.

ï Analyze reports from the administrative software for provider and member utilization trends and identification of areas requiring further management.

ï Support the Team leader / Manager in implementation of quality assurance programs in order to maintain standards of quality and minimize fraudulent cases.

ï Handling medical related call queries.

ï Maintain confidentiality with regard to the information being processed, stored or accessed.

ï Completes other projects and duties as assigned.

Skills and qualification requirements :

ï Should be willing be to work shifts (morning, evening and night shifts)

ï Must be an MBBS Graduate

ï Candidates able to start immediately preferred

ï 2 years minimum clinical experience

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