Claims Verifier- COS/EPS
2 days ago
The Claims Verifier is responsible for entering and adjudicating a member's out-patient claims based on received claims documents, provider and health plan contractual agreements and claims processing guidelines to ensure the proper recording and computation of client/member utilization as well as processing of payment in accordance with the SLAs to our accredited providers (particularly clinics, doctors and dentists).
Job Qualifications:
- Graduate of Business or Medical course
- Preferably with at least 1 year of related working experience in claims verification or in an HMO Setting
- Knowledgeable in medical terminologies
- Willing to work on shifting schedule
Job Competencies:
- Possesses good written and communication skills
- Proficient in Microsoft office applications
Personal Character:
- Is able to work effectively under pressure
- Possesses a sense of urgency and attentive to details
- Work oriented and flexible
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