Medical Claims Officer

Introduction :

Our client, a Medical Insurance Company is looking for a high calibre candidate to fulfill the above-mentioned position. Details are as followings :

Responsibilities :

• Adjudicate claims according to policyholders policy provisions and approves claims up to allowable limit of approval in a professional and effective manner within the turnaround time;
• Handle GOP request from insured, brokers, network facilities or emergency assistance company for outpatient and inpatient cases;
• Cooperating with emergency assistance company for emergency cases during and outside of office hours;
• Handle inquires and complaints from regional offices and Customer Services Department;
• Handle outgoing claims advice to customers, brokers and regional offices;
• Coordinating with regional offices and Finance Department in delivery of claims payment to client and medical providers;
• Monitor claims input by regional offices;
• Assist Claims Manager to undergo UAT in system enhancement;
• Carry out ad-hoc duties as assigned by the Company.

Requirements :