PURPOSE:
Responsible for receiving and processing claims for provider payment.
PRIMARY RESPONSIBILITIES:
Receiving of claims- Ensure all claims received are verified, well stamped and keyed in for future reference.
Dispatch received invoices, mails and claim books to respective sections
Dispatch claim forms and other relevant documents to providers
Respond to walk in customer enquiries
Prepare valid received claims for scanning
Scan, index, and upload prepared invoices and reference to Document Management System
Facilitate disposal of claim documents as per approved disposal procedure
Verification of correct billing of E-claims
Registration of claims in the system for provider payments
Follow up on registration and reconciliation of provider statements to ensure closure.
Attend to customer and service providers' queries and complaints promptly and professionally.
Key Skills, Knowledge, Experience and Behavioural Competencies
Academic and Professional Requirements
Education Bachelor's Degree Bachelor's degree in Commerce or in a related field
Professional Qualifications Progress towards IIK/CII may be an added advantage
Experience Required:
One year Relevant experience
