Job Description

Process Overview*

• Health insurance intake claims Intake processing for individual, employer, group, and provider and general administration duties.

Job Description*

Responsible for organizing and processing the flow of incoming and outgoing documents (paper & electronic) in a back-office environment. The candidate ensures there is consistency in timely delivery of quality and quantity to meet set parameters measures to meet Service Level Agreements

Responsibilities

• Receiving and documenting claims both electronic and paper claims
• Sorting, processing, and vetting of claims firsthand for claims payment and ensuring they are accurately assigned.
• File management and classification of data and supporting reporting compilation.
• Electronic transfer of received claims to the various platforms.
• Managing the flow between members and provider claims
• Processing member and provider claims within stipulated Turn Around Times
• Managing the different channels through which claims are received.
• Cross referencing of emails received from members and providers for further processing.
• Any other tasks as allocated.

Requirements*:

• Active language knowledge of at least English (additional languages are a plus)
• Executes assignments accurately and pays attention to detail.
• Ability to plan and organise tasks independently.
• Excellent time management skills with ability to continuously prioritize set tasks accordingly.
• Upholds utmost discretion when handling confidential information.
• Ability to handle large quantities of paper and electronic documents.
• Works to deliver consistently even under pressure.
• Self-Driven and can work with little or no supervision.
• Ability to work collaboratively within a team.
• Proficient in the use of Spreadsheets, word-processing and associated office IT Skills with CRM systems (e.g.) Salesforce with accurate data inputting.
• Accountability assumes ownership for achieving personal results.
• Customer focused while executing mundane tasks.
• Copes well in a changing environment

Job Classification

Contact Details: