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Job Description
Job Summary
The Claims Coordinator is responsible for the timely processing of claims for all patients.
Major Duties and Responsibilities
- Accurately provide information to all incoming inquiries regarding claims, disputes, claim information, procedures, and regulations.
- Review claim requests and respond within established service level agreements
- Assists in managing departmental claim activities to ensure that payouts are adjudicated in an accurate and efficient manner
- Effectively ensure that detailed electronic records are maintained by accurately documenting all actions taken.
- Meeting measurable department standards as they relate to call quality, claim accuracy and efficiency measures as well as meeting teamwork, ownership, and professional development goals
- Reviews ER/OPD discrepancies and communicating with respected departments.
- Reviews the received claim forms if the ID copy attached is correct and form is complete.
- Reports the unadjusted and un-entered medical services to Manager of claims notification of excluded services for the newly contracted companies.
- Receives answered approvals from PSD, the Admission office and the Billing department.
- Takes ownership of customer claims by following requests through to completion and notifying appropriate personnel if problems exists.
- Display actions that align with our Vision, Mission, and Values
- Performs additional tasks and duties as assigned by superiors.
Skills
- English and Arabic speaking and typing.
- Computer literate (MS Office)
- Familiar with Medical Terminology
- Expert in Payers regulations
Job Details
Job Location
Riyadh, Saudi Arabia
Job Role
Administration
Employment Type
Employee
Preferred Candidate
Career Level
Entry Level