Angetha Atis Email & Phone Number

As a claims Admin Assistant I am required to:- Logging and saving of Claims and Pre-authorization requests - Processing of claims on behalf of policy members (to pre-screen/submit/follow-up/monitor/update claims record in the client database)- Communicating with colleagues, insurers and policy members in relation to claims or pre-authorization processes/issues (ie.Delayed/pending/declined)-Communicating with members (emails or calls) on claim questions, basic benefit enquiries and/or complaints- Organizing follow ups related to claims with insurance companies and policy members in an efficient and pro-active mannerensuring they are updated on the statusof their claims/pre-authorization at all times-Updating and monitoring Claim records/follow-ups- Providing excellent customer service to clients and support with their claims- Using critical thinking and policy knowledge to analyze whether the insurer has processed a claim correctly and managing claims appeals (of reasonable nature) withinsurers including pre-authorization cases that were declined until all options/means/approach have been fully exhausted- Ensuring that problem claims are escalated to the Manager in a timely manner if it becomes too difficult to handle- Handling direct-billing and e-claiming/online portal/mobile app enquiries and issues when appropriate (i.e. pro-actively calling insurance companies andclinic/hospitals to arrange direct billing/ensure direct billing is available)- Processing of pre-authorization requests and emergency procedures including liaising with clinics/providers if necessary

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  University Of Cebu

  Accounting