Deskripsi Pekerjaan
Join Cocolife's dynamic team as an HMO Claims Associate and become a vital part of our healthcare operations. In this role, you'll ensure the accurate and timely evaluation of medical claims, directly impacting our members' access to quality healthcare services. You'll meticulously review claim submissions, verify documentation, and process reimbursements while maintaining strict compliance with industry regulations and company policies. This position offers a unique opportunity to develop expertise in healthcare administration while contributing to a company dedicated to financial security and wellness solutions. If you thrive in detail-oriented environments and possess a passion for supporting healthcare providers and members, this role will provide both professional growth and meaningful impact.
Tanggung Jawab
- Evaluate and process HMO medical claims with precision and timeliness
- Review claim documentation for completeness, accuracy, and adherence to policies
- Investigate and resolve claim discrepancies through effective communication
- Maintain accurate claim records and documentation in compliance with regulations
- Collaborate with healthcare providers to obtain missing information
- Ensure adherence to company guidelines and industry standards
- Support continuous improvement of claims processing workflows
Kualifikasi
- Bachelor's degree in Nursing, Medical Technology, Healthcare Administration, or related field
- 1+ years of experience in claims processing or healthcare administration
- Proficiency in claims management software and MS Office applications
- Strong attention to detail and analytical problem-solving skills
- Excellent verbal and written communication abilities
- Knowledge of medical billing procedures and insurance regulations
- Ability to work efficiently in a deadline-driven environment