Claims Manager

Responsible to monitor and control the Billing & Claims Operations.

Approves and re-checks all monthly corporate claims submitted by the Claims Supervisor.

Check the missing documentation report prepared by Claims Supervisor on daily basis.

Reviewing and validating the invoices and claims.

Making needed communication with other department such as (PSD, Lab, physiotherapy, Approval etc...)

Finalization and closing of claims monthly.

Preparing and submitting monthly claims report.

Takes part in drafting contracts with the new insurance companies.

Suggests new computer functions to improve the section performance.

Prepare refund of payment for services & investigation as per the instruction of the Claims Manager.

Check on daily basis the in-patient billing if any adjustment would be required.

Check if there are any services or medication without service code for charging purpose.

Performs additional tasks and duties as assigned by Superiors.

Qualifications:

Education:

College Graduate/Bachelor of Science in Business Administration, preferable Major in Management/Accounting

Experience:

A minimum of:

seven (7) year experience in a similar position especially in patient accounts.

Good knowledge of computer applications MS Office (especially MS Excel).

Good command of both written and oral English language.

Good communication & interpersonal skills.

Familiar with Medical Terminology

Tact, courtesy and public relations skills are a must.