CLAIMS EXECUTIVE / ASSISTANT

Responsibilities

• Adjudicate claims for admission, outpatient, and major claims.
• Compile supporting documents (including police report for MVA and assault claims) as attachments with each claim submission to relevant clients.
• Prepare claims bordereaux for submission to client/Finance Department together with the compiled supporting documents.
• Ensure timely submission of claims and monitor closely on claims settlement timeline.
• Prepare performance and productivity reports as required.
• Attend to inquiries regarding claims operating procedures at CompuMed.
• Deliver quality customer service and appropriate solutions regarding medical/insurance claims and clinical services issues.
• Provide a polite, professional and accurate response in accordance with the agreed service standards.
• Liaise with hospital personnel regarding the management of a member during pre-hospitalization, hospitalization, ...