Reconciliation Specialist

Job Purpose:

This role is responsible for processing reconciliation requests from accredited providers distributed by the PPM-AM. Responds to the queries and provides updates on the status of claims on a timely manner. Ensure active status and be able to secure Certificate of Good Credit Standing from the facility/institution.

Principal Accountabilities:

• 1. Claims Reconciliation Processing
  • 1.1 Review the provider sent list vs iCare records
  • 1.2 Coordinate with the provider for any lacking requirements within 3 days from the receipt of the claims.
  • 1.3 Coordinate with Claims and Accounting for processing and payment posting
  • 1.4 Monitor progress and update the PPM tracker daily
  • 1.5 Assist PPM-AM in securing Certificate of Good Credit Standing
• 2. Reports
  • 2.1 Update the performance tracker daily
  • 2.2 Endorse to PPM Head Threats/Suspension list and information re...