Position Overview
Job Functions:
• Input claim data into the system, ensuring all information is accurate, up-to-date, and properly filed.
• Assist in collecting and organizing all necessary documentation for claims, including medical reports,
receipts, and forms.
• Review and assess claims to determine their validity, ensuring all necessary documentation is submitted and
in compliance with relevant regulations.
• Analyze claims data to identify discrepancies, fraud, or errors and escalate complex claims to senior claims
staff or managers.
• Conduct initial investigations when necessary to gather additional information or verify claims details.
• Ensure compliance with industry regulations, company policies, and procedures in handling claims.
• Follow up with claimants, healthcare providers, or third-party vendors to ensure timely resolution and
payment.
• Communicate with various de...