Position Overview
Job Functions:
β’ Input claim data into the system, ensuring all information is accurate, up-to-date, and properly filed.
β’ Assist in collecting and organizing all necessary documentation for claims, including medical reports,
receipts, and forms.
β’ Review and assess claims to determine their validity, ensuring all necessary documentation is submitted and
in compliance with relevant regulations.
β’ Analyze claims data to identify discrepancies, fraud, or errors and escalate complex claims to senior claims
staff or managers.
β’ Conduct initial investigations when necessary to gather additional information or verify claims details.
β’ Ensure compliance with industry regulations, company policies, and procedures in handling claims.
β’ Follow up with claimants, healthcare providers, or third-party vendors to ensure timely resolution and
payment.
β’ Communicate with various de...