Claims Automation Associate at Reliance HMO

Job Summary

• This role is responsible for setting up and utilizing clinical knowledge, data analytics as well as programming inputs to optimize the performance of our automated claims processing system.

Job Description

• Adjudicate health insurance claims.
• Apply clinical knowledge and basic programming skills in automating claim adjudication using a web-based project.
• Utilize data analytics to derive insight and patterns that affect the performance of the claim automation system.
• Apply continuous process improvement to the claim automation system.
• Provide periodic reports on the performance of the claim automation system.

Job Requirements

• Minimum of a First Degree in Medicine, Nursing or Healthcare / Medical discipline.
• Basic understanding of data analytics and a willingness to learn programming languages is essential.
• Previous experience in a claims examiner role is an added advantage.
• Excellent numeracy, analytical and problem-solving skills.
• Strong medical and clinical knowledge and experience.
• Excellent interpersonal and communication skills.