mining and analytic investigations to spot underlying root causes on behalf of the Claims Analyst and Management. Provide... in medical claims processing and analysis Familiarity with insurance policies and industry regulations Strong analytical skills...
Job Summary With moderate direction, handles single and multi-party personal or commercial line claims of low... to moderate exposure and complexity within specific limits of authority by following established protocols to ensure that claims...
years of experience Technical Skills: Claims assessment, Medical report knowledge, Health Insurance Policy knowledge... insurance claims Roles & Responsibilities: To support and lead a team of assessors in pre-certification, hospitalization, case...
: Bachelor's Degree in Medicine or medical fields Years of Experience: Minimum 2 years of experience Technical Skills: Claims... assessment, Medical report knowledge, Health Insurance Policy knowledge Industry: Health Insurance, Third-Party Administrator...
or medical fields Years of Experience: Minimum 2 years of experience Technical Skills: Claims assessment, Medical report... of individual health insurance claims Roles & Responsibilities: To support and lead a team of assessors in pre-certification...
regarding claims for cases pending litigation if required. Communicates and interacts with medical professionals, support... responsibilities: Reviews and evaluates all claims for completeness and clarity of data; supporting documents, as needed, to ensure...
and guidelines Establish covered medical insurance losses against benefits coverage and eligibility. Adjudicate medical claims..., hospital details, type of medication, procedures & etc. Escalate questionable claims to the direct supervisor / medical...
business analyst Key Responsibilities To perform the following duties and responsibilities: Obtain necessary claims..., solicitors for summon cases & medical specialists. Confirm coverage and assess claims based on documents / reports that support...
and understand clients' needs and concerns. Collaborate with cross-functional experts from Client Markets, Underwriting, and Claims... (e.g., Thai, Vietnamese, Mandarin, Bahasa Malaysia/Indonesia) are desirable. Experience in medical reimbursement pricing...