Job Purpose:
Responsible for sorting and registering all the received claims, dispatching them to Medical Claims Administrators, then dispatching and filing all the claims following processing. This includes checking claim applications for accurate completion and ensuring that all the necessary medical evidence has been submitted.
Main Accountability:
- Receive and acknowledge to providers for submitted claims and to maintain records in tracking sheet.
- Receive distributed claims from the Team Leader.
- Sort & register all received claims and ensure claims are properly documented.
- Sort out the out of KSA and not GIG claims to dispatch.
- Ensure the quality of work by avoiding the duplicate entries, wrong provider code entries and to ensure that the registered amount is tallying with the billing amount.
- Ensure that all claims documentation is filed ,lot number allocated ,claim receiving date is mentioned and stored in the dedicated manual and/or electronic retrieval system.
- Ensure that the tracker/shared excel sheet is maintained on daily basis with all required fields.
- Prepare claims files to the corresponding Medical Claims Administrator.
- Notify the provider with the price discrepancies after registration.
- Scanning of documents ,if scanner module is used for claims registration.
- Registration of claims by CSV import module.
- Other tasks as assigned by Supervisor or HOD.
Qualification & Experience Required:
- Bachelors of health information management or related field preferred.
- 0-3 Years in Insurance Company.
- Computer Skills, Word, Excel and Data entry.
- Excellent communication skills.
- Good time management.
- Good typing speed.
