Job description / Role
SUMMARY
Evaluate more complex data entry, clerical, and accounting tasks involved in the preparation and processing of patient insurance claims. Supervises releasing team with regards to productivity and efficiency.
MAIN TASKS
- 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 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.
Filing/Monitoring
- Stands as a reference person for information on inquiries concerning claims processing procedures.
- Monitors correct application of beneficiary share accordingly on service items billed.
- Makes sure that claims are properly audited of all data entered with accurate medical claims details.
- Notes all discrepancies during the course of the system process are properly forwards and notifies to immediate supervisors.
- Provide requisition of office supplies for Individual and Team requirement.
Other Duties
- Researches claims as needed
- Obtains and audit medical records to compute and record patient charges.
- Performs other related duties incidental to the work described herein.
BEHAVIOURAL REQUIREMENTS
- Attention to detail and ability of multi-task.
- Organizational & time management skills.
- Excellent team player.
- Ability to meet tight deadlines.
- Ability to work under pressure to tight deadlines.
- Strong communication skills.
- Ability to work well with all levels of internal management and staff, as well as outside clients and users.
- Ability to demonstrate sounds work ethics.
- Show flexibility with excellent interpersonal skills.
- Flexible to work in shifting schedule.
- Demonstrate commitment to produce output base results.
Requirements
BEHAVIORAL COMPETENCY
Customer & Market Excellence:
- Strive for excellence at every touch point with the customer
- Foster state-of-art technical/operational knowledge and strive for continuous simplification
- Be the benchmark
Collaborative Leadership:
- Empower the team and provide purpose and direction
- Develop people, provide feedback and care to employee wellbeing
- Collaborate and exchange best practice.
Entrepreneurship:
- Act on opportunities, anticipate trends, take risk, and promote a culture that allows for honest failure
- Take ownership and responsibility
- Embrace innovation and a culture that allows to make decisions without fear of retribution.
Trust:
- Act with integrity, honor commitments, tell the truth
- Foster diversity and inclusiveness
- Act transparently and promote corporate social responsibility.
About the Company
With over 159,000 employees from 172 nationalities across more than 70 countries, we are one of the world's most trusted insurance and asset management companies. We offer a broad range of products and services in property/casualty insurance, life/health insurance, and asset management. We have our largest operational presence in Europe, and our parent company, Allianz SE, is headquartered in Munich, Germany. From jobs in Actuarial, Business and IT to Inhouse Consulting and Investment Management - your opportunities are endless!