Claims Processors

مجموعة الموسى الصحية-Arábia Saudita

DUTIES AND RESPONSIBILITIES:

  • Direct report to Liaison Physician.
  • Evaluates and identifies the company’s requirements and makes appropriate recommendations in commensurate with the established policies and procedures.
  • Evaluates proposal received from companies Company for all coverage, conducts analysis, and submits reports with recommendations.
  • Receive Inpatient cases (PPS/SPS/Regular admission) and ensuring that documents are complete and arranges.
  • Receive daily finished claims and print companies invoice in each claim.
  • Submit finished claims to be perform by Liaison Physician.
  • Submit requested claims to Physician that require review.
  • Receive approved services.
  • Receive rejected claims and re-worked on it for resubmission.
  • Check billed statements according to requiring confirmation confirmed and rejected summarization all status
  • Keep communicate to Aramco Accounting Office in all matters.
  • Comply with the requirements and coverage of policy provided by Aramco.
  • Work on PCP monthly for the payment.
  • General Supervising in Claims department.
  • Provide personalized coordinated care, and support for patients and families.
  • Treat people with dignity, compassion, and respect.

QUALIFICATIONS:

  • Diploma

PROFESSIONAL EXPERIENCE:

  • 0- 2 years

SPECIALIZED SKILLS:

  • Skills and computer literate.
  • Excellent knowledge of oral and written English.