Receive, Organize and Register Network Providers Claims to create initial records of received claims.
Monitor Network Claims submission status in coordination with Network team.
Screen and Highlight submission issues to providers on a detailed and efficient manner.
Ensure that all claims received from different sources such as mail, paper, e-claims, regulatory portals are registered as a batch in the system including amount, count etc.
All claims are scanned and uploaded in the system and notified to the Claims team on daily basis.
Ensure timely delivery of the daily scanned claim targets.
If any, manual rejections should be documented and sent to PICs and Providers such as rejection and deleted member tracker.
Preparing and aligning the e-claim file submissions of providers as per the required format and data fields and upload into the core system.
Generating claims summary reports that will be used by processors and other departments.
Dispatch of claims to the PICs as per the agreed timeline and coordinate with them for any query or clarification.
Provide the status of claims and batch numbers to providers.
Ensure maintaining of update to date physical claims receiving and statement of account trackers.
Excellent communication skills. (English)
Health Insurance industry / Market knowledge would be an added advantage.
Ability work under strict deadlines and handle stress.
Advanced Knowledge on MS Office especially in MS Excel
Quality focus and customer oriented
Preferable Omani National (Male)
Bachelors or Diploma degree in Business Management or related fields.
1-2 years of experience.