CLAIMS ACCESSOR at Oceanic Health Management Limited

Job Duties/ Responsibilities/ Accountabilities:

• Coordination of the medical claims.
• Receipt and registration of Provider claims.
• Keying-in of Provider claims.
• Adjudication of claims.
• Processing of claims within contractual timelines.
• Management of medical expenses within benefits.
• Preparation and collation of Provider claims, sending reviews and reports.
• Attendance of internal meetings to enhance productivity and profitability.
• Ensure all administrative reports are sent within allotted timelines.
• Unit document filling and record keeping.
• Escalation of unit requirements to other relevant internal stakeholders.
• Vetting of member reimbursement documents in accordance with incidental circumstances and agreed rates.
• Any other task and duty as assigned by the head of unit.

Requirement

• Education Qualification: Registered Nurse(preferably) or BSC (with industry experience)
• Data Analytics tools certification
• Experience (Dimension and No of years): Minimum of one year in similar role

Functional/ Technical:

• Good clinical skills
• Apt administrative skills
• Proficient in Microsoft office tools

Managerial:

• Ability to multi-task
• Problem solving
• Analytical expertise
• Discrete
• Behavioral:
• Conscientiousness
• Excellent Communication skills
• Time management skills
• Organizational skills
• Interpersonal skills