Deskripsi Pekerjaan
Private Advertiser is seeking a dedicated and detail-oriented HMO Staff member to join our growing healthcare team. In this pivotal role, you will serve as the bridge between our clients and their medical benefits, ensuring accurate processing of claims and providing exceptional support. We pride ourselves on a fast-paced environment where your organizational skills will directly impact patient satisfaction and operational efficiency. If you are looking for a challenging yet rewarding opportunity in the medical administrative field, this is the perfect place for you. We offer a collaborative work culture and the chance to grow your career within the healthcare sector. Your expertise in handling sensitive information and navigating insurance protocols will be vital to our success.
Tanggung Jawab
- Process and verify HMO claims, referrals, and medical records accurately and in a timely manner.
- Assist HMO members and healthcare providers with inquiries regarding coverage, benefits, and claim status.
- Coordinate with various medical departments and external HMO entities to ensure seamless service delivery.
- Maintain and update patient records, insurance files, and databases with precision.
- Prepare and submit required documentation for reimbursement and accreditation purposes.
- Monitor claim denial rates and work proactively to resolve discrepancies and appeals.
- Provide administrative support to the healthcare management team as needed.
Kualifikasi
- High school diploma or Bachelor’s degree in Medical Technology, Nursing, or Business Administration preferred.
- Previous experience in an HMO, hospital administrative, or insurance setting is an advantage.
- Strong understanding of medical terminology, insurance processes, and healthcare regulations.
- Excellent verbal and written communication skills in English.
- Proficient in MS Office applications and relevant hospital management software.
- Ability to work under pressure and manage multiple tasks efficiently.
- Strong interpersonal skills and a genuine passion for helping others.