Fresh Jobs at RelianceHMO

The Position

The ideal candidate will work in the Tech Team of RelianceHMO, and will specifically support the use of all hardware and software tools within the organisation.

You are a team player – able to work across different stakeholders, communicate expectations openly and clearly, and welcome constructive feedback.

You’ll love this opportunity because…

• you'll have a lot of independence in managing projects
• we have a vibrant and active culture
• co-workers are a close-knit, intelligent, and motivated team

Key Responsibilities

• Test, install and configure software and computer hardware systems such as PC, printers, etc
• Monitor, troubleshoot and resolve issues with software, hardware or network systems.
• Walk colleagues or client through steps to help them resolve their technical problems.
• Support the implementation of new solutions or applications.
• Establish accounts for new users and assist with password or login problems.
• Ensuring all logs for equipment and users are maintained.
• Create instructional guides for troubleshooting issues.
• Ensure excellent customer service and support is provided to all internal and external customers.
• Manage time and effectively prioritise numerous tasks at one time.
• Study related IT problems and identify solutions.
• Correspond with related vendors in resolving IT matters.

Must Haves

• Minimum B.Sc/HND in Computer Science, Computer Engineering, or closely related fields.
• Minimum 1 year relevant work experience.
• Excellent knowledge of Microsoft Office apps such as Word, Excel, Outlook etc
• Sound knowledge of technical requirements of various software applications.
• Sound knowledge of various computer hardware and software configurations for Windows & MacOs.
• Sound knowledge of requirements with various utility software applications such as Antivirus.
• Good analytical and problem-solving skills.
• Excellent interpersonal and communication skills.
• Experience with technology relative to the industry is an added advantage (Call Center tools, etc).
• Flexibility to respond to issues at odd hours of the day.
• Excellent time management

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The Position

The ideal candidate for this role is someone with a start-up mentality who is ready to work hard and push the limits in ensuring claims vetting and management process is a success. The Senior Claims Associate will be responsible for vetting all claims submitted by our Providers to ensure they are error and fraud-free. They will manage claims payment and be involved in the resolution of medical cases requiring special attention.

You are a team player – able to work across different stakeholders, communicate expectations openly and clearly, and welcome constructive feedback.

You’ll love this opportunity because…

you'll have a lot of independence in managing projects
we have a vibrant and active culture
co-workers are a close-knit, intelligent, and motivated team

Key Responsibilities

• Examine Healthcare Providers’ Claims using Tariff agreement to determine authenticity & payment.
• Decline fraudulent Healthcare Providers’ Claims, and state causative reasons.
• Forward approved Claims to Team Lead for review and final approval.
• Investigate complicated Claims and escalate to Team lead, if necessary.
• Carry out physical inspection at the assigned provider’s office using the checklist.
• Investigate complicated claims by checking the case folder and speaking to Enrollee and doctor.
• Escalate fraudulent cases to the Committee of Doctors.
• Update Providers’ dashboard and implement resolutions.
• Relate with the Customer Success team to manage concession requests.
• Relate with technology team on any update on the processes regarding the claims of Providers.
• Relate with Provider Relations Service unit for tariff agreement.

Must Haves

• Minimum of a Bachelor of Medicine and Bachelor of Surgery (MBBS).
• Minimum 2 years relevant work experience in a similar role
• Excellent numeracy, analytical and problem-solving skills.
• Strong ability to make judgement on medical/ surgical cases in relation to enrollee’s benefits.
• Ability to make professional judgement on coverage and non-coverage of care requests per time.
• Excellent interpersonal and communication skills.