Job Description*
Responsible for organizing and processing the flow of incoming and outgoing documents (paper & electronic) in a back-office environment. The candidate ensures there is consistency in timely delivery of quality and quantity to meet set parameters measures to meet Service Level Agreements
Responsibilities
- Receiving and documenting claims both electronic and paper claims
- Sorting, processing, and vetting of claims firsthand for claims payment and ensuring they are accurately assigned.
- File management and classification of data and supporting reporting compilation.
- Electronic transfer of received claims to the various platforms.
- Managing the flow between members and provider claims
- Processing member and provider claims within stipulated Turn Around Times
- Managing the different channels through which claims are received.
- Cross referencing of emails received from members and providers for further processing.
- Any other tasks as allocated.
Requirements*:
- Active language knowledge of at least English (additional languages are a plus)
- Executes assignments accurately and pays attention to detail.
- Ability to plan and organise tasks independently.
- Excellent time management skills with ability to continuously prioritize set tasks accordingly.
- Upholds utmost discretion when handling confidential information.
- Ability to handle large quantities of paper and electronic documents.
- Works to deliver consistently even under pressure.
- Self-Driven and can work with little or no supervision.
- Ability to work collaboratively within a team.
- Proficient in the use of Spreadsheets, word-processing and associated office IT Skills with CRM systems (e.g.) Salesforce with accurate data inputting.
- Accountability – assumes ownership for achieving personal results.
- Customer focused while executing mundane tasks.
- Copes well in a changing environment
- Education*: new Diploma and Bachelors degree (Any) – medical, Paramedical, Commerce, Statistics, Mathematics, Economics or Science, guided by job market
- Experience Range*: Role open to new or early career Diploma and Bachelors Degree, guided by job market
Foundational Skills* –
- Routine Operations Tasks execution
