Deskripsi Pekerjaan
Join RELIANCECARE Inc as a Medical Claims Processor Specialist and become a vital part of our healthcare operations team. In this role, you'll be the backbone of our claims processing department, ensuring employees receive timely and accurate benefit reimbursements. You'll meticulously review medical claims documents, verify eligibility against insurance policies, and maintain precise data records. Your attention to detail will directly impact client satisfaction and operational efficiency as you coordinate across departments to resolve discrepancies and ensure compliance with regulatory standards. This position offers an opportunity to develop expertise in healthcare administration while working in a dynamic environment that values integrity and excellence.
Tanggung Jawab
- Review and validate medical claims documents for completeness and accuracy
- Verify employee eligibility and coverage against insurance policy guidelines
- Perform precise data entry of claim information into company systems
- Coordinate with healthcare providers and internal departments to resolve claim discrepancies
- Ensure compliance with insurance regulations and company policies
- Maintain organized records of processed claims and documentation
- Communicate claim status updates to employees and stakeholders
Kualifikasi
- Bachelor's degree in Healthcare Administration, Business, or related field
- Minimum 1-2 years of experience in medical claims processing or insurance administration
- Proficiency in data entry and claims management software
- Strong knowledge of insurance policies and claim procedures
- Excellent attention to detail and organizational skills
- Ability to work independently and meet processing deadlines
- Strong communication and interpersonal skills
- Basic understanding of healthcare terminology and billing codes