Claims Management Processing Officer

Responsibilities:

• Ensures that insurance claims information is entered into the system correctly, to ensure accurate processing and timely payment.
• Ensures that provider’s fees and service items charges coincide with their existing contract price list with Nextcare.
• Ensures the accuracy of the entered data as per the existing standard steps and procedures of direct claims processing.
• Compares data on claims applications.
• Screens claim documents and process claim adjustment.
• Ensures Payment Orders are properly created and forwarded accordingly for final releasing, documentation and filing.
• Ensures adaptability in various work-related tasks to be able to facilitate a multi-tasking role.
• Ensures that high quality standard of work performance is achieved at all times.