
Senior Claims Operations Specialist
16 hours ago
Job Overview:
">We are seeking a skilled Claims & Operations Manager to oversee our claims processes, daily operations, and system management.
">This role requires strong problem-solving skills, the ability to multitask in a fast-paced environment, and a customer-focused mindset.
">- ">
- Manage and audit claims forms, medical reports, and related documentation.">
- Liaise with clinics, hospitals, and insurers to ensure timely and accurate claims submission.">
- Track and monitor claim progress, ensuring prompt closure and regular status updates.">
- Maintain and update claims data and summaries in internal systems.">
- Pre-assess claims, review estimates, and identify improvements to submission processes.">
- Provide claims-related advice to internal teams and management.">
- Oversee patient operations including admissions, discharges, consultations, and follow-ups.">
- Supervise daily operations to maintain service quality and compliance.">
- Ensure accuracy of patient and insurance information in all records and systems.">
- Support system improvements and process enhancement initiatives.">
- Organize company meetings and events, including accurate minute-taking and coordination.">
- Report incidents, feedback, or operational issues promptly to management.">
- Mentor and guide junior staff in claims and operational matters.">
- Generate reports and insights for management as required.">
- Uphold company standards, confidentiality, and service excellence at all times.">
Requirements:
">- ">
- Strong relationship management and interpersonal skills.">
- Excellent written and verbal communication abilities.">
- Resourceful, analytical, and detail-oriented with strong problem-solving skills.">
- Resilient, adaptable, and able to multitask in a fast-paced environment. Confident, service-oriented, and committed to maintaining patient confidentiality.">
- Proactive team player with strong organizational skills.">
- Flexibility to support ad-hoc duties and respond promptly to queries.">
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