Job Description
To ensure that all provider payment shall be delivered within timeline with 100% accuracy. and support providers and Provider Relations department to comply with the regulation requirements within the agreed policy and procedural protocols
Payment Types:
- Reviewing the GSS(General Summary Statement) & Tax Invoice received from the provider if data presented are correct and no missing data before requesting the agreed payment. Assisting with the implementation of new processes and procedures.
- Submitting all requested payments received within the same day to maintain the 1 day sub KPI payment with 100% quality.
- Ensuring the correct percentage of deduction for providers having a recovery amount.
- Coordinate with Finance and Claims to resolve payment issues
- Ensuring that all initial statements are paid withn the agreed KPI.
- Responsible in checking all pending claims in the system, dummy members against cognos report by amending any claims pending.
- Reviewing all the necessary attachments before ticking settled and generate statement in the batch header maintenance tick box.
- Checking each provider in the list of fraudulent before processing their payment
CHI & NW:
- Maintaining Bupa NW compliant to regulator who mandated that provider's contracts should be terminated once their CHI accreditation has expired.
- Securing the authorized forms for all NW monthly update and maintaining the accurate update through system.
Project Support:
- Support Manger during project implantation by providing logistical and planning support.
- Ensure post-implementation benefits realization are reported accurately and on timely manner.
Skills
- Advanced Excell Skills
- Proficiency in English and Arabic (spoken and written)
- Communication Skills
- Negotiation Skills
- Bachelor degree in science majors
- Expert in editing and validating numerical data
