
Medical Claims Manager
5 days ago
We are seeking a highly skilled professional to join our claims team in the healthcare industry. As a claims manager, you will be responsible for the accurate and efficient adjudication of claims, validation, pre-authorisation of applications, and issuance of log documents to meet operational and SLA targets.
Key Responsibilities:
- Provide expert-level claim adjudication and validation services;
- Develop and implement new processes to improve efficiency and overall claims experience;
- Manage stakeholder relationships and escalations;
- Drive change and provide training on effective claims management practices;
- Collaborate with insurance companies to resolve exceptions and complaints.
Requirements:
- Strong technical understanding of medical claims processing in a Third-Party Administrator/Managed Healthcare environment;
- Exceptional interpersonal and organisational skills;
- Excellent eye for detail and exceptional communication skills;
- Passion for driving business outcomes and improving efficiency;
- Proven ability to work independently and effectively manage stakeholder relations.
Benefits:
- Opportunity to work in a dynamic and fast-paced environment;
- Chance to develop your skills and expertise in claims management;
- Collaborative and supportive team culture.
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