✨ AI Summary
The Medical Claims Officer will be responsible for performing technical audits on medical claims, evaluating claims for eligibility, and reviewing claims to ensure all required information is included. Key responsibilities include performing accurate and timely data entry, extracting claim printouts, and maintaining high accuracy and productivity standards. The role requires collaboration with colleagues to achieve shared goals and adherence to organizational policies and procedures.
Required qualifications include a Bachelor's degree in Pharmacy, a minimum of 2 years of experience in a similar field, strong interpersonal and negotiation skills, and the ability to handle stress in a fast-paced environment. Detail-oriented and strong organizational skills are essential for effective workload prioritization. Candidates should be able to work independently and as part of a team, meet tight deadlines, and be fluent in English. Proficiency in Microsoft Office (especially Excel) and other relevant software applications is necessary.
Requirements
Bachelor’s degree in pharmacy2+ Years of experience in a similar fieldGood interpersonal and negotiation skills.Ability to handle stress and work in a fast-paced environment.Detail-oriented and Strong organizational skills to prioritize workload effectively.Ability to work independently and as part of a team.Ability to meet tight deadlines.Fluency in English, both written and spokenProficiency in Microsoft Office (Specially Excel) and other relevant software applications.
Description
We are seeking a skilled and detail-oriented Medical Claims Officer to join our team. The MedicalClaims Officer will be responsible for performing technical audits on medical claims, evaluatingclaims for eligibility, and reviewing claims to ensure that all required information is included. Theideal candidate should have a strong medical background, be highly organized, detail-oriented,and possess strong communication and interpersonal skills. They should be able to workeffectively as part of a team and manage a high volume of claims while maintaining a high levelof accuracy and productivity. These activities should adhere to the organization’s agreed policies,procedures, and guidelines.Role:-Perform technical audits on medical claims and assess their eligibility to ensure that theymeet policy guidelines.Review claims to ensure that all required information is included.Perform accurate and timely data entry of claim processing.Ensure that all claims’ printouts are extracted from the system properlyMaintain a high level of accuracy and productivity while meeting established performancemetrics and quality standards.Work collaboratively with colleagues in a team environment to achieve shared goals.