Job Description

Role & responsibilities Clinical Support & Processing Specialist [Back-office] Strong understanding of Benefits industry products, coverages and processes Ability to effectively manage workloads - Exercising the ability to operate across systems simultaneously, and appropriately review some complex claims Possess knowledge and understanding of claims review, deficiency management and operations of Benefits Systems. Prompt Decision Making - Ability to assess claims scenario and undertake a timely, accurate claims review and missing data follow up Collaboration and Understanding Effectively collaborate and build relationship with providers, employers, internal and external partners etc. Problem-Solving : Applies critical thinking to update claims cases across various platforms. Attention to Detail : Ensures accuracy in claims by verifying incoming supporting documents and data meticulously, processing incoming invoices accurately to avoid underpayment, duplicate or overpayment. Organizational Skills : Manages workload efficiently, meeting deadlines especially during high claims volume spikes. Team Collaboration : Fosters teamwork and performs diverse tasks related to claims administration and services effectively. Adaptability and Learning : Learns new skills and procedures, applying expanded knowledge to complex situations and special projects.