Claims Specialist (Project-based)
Processing of claims, recurring schedules/reimbursements and card substantiation for products or services rendered & premiums related to healthcare in accordance with rules set by the clients.
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Processing of claims, recurring schedules/reimbursements and card substantiation for products or services rendered & premiums related to healthcare in accordance with rules set by the clients.
Processing of enrollments, changes, terminations, and audits in accordance with the rules set by the clients. Managing the administration of employee benefits in accordance with the rules set by the clients.
Validating data and sets of information downloaded from the client system in compliance to the client’s instructions and standard operating procedure.
Validating and reviewing the system set-up based on test scripts and client requirements.
Assisting on the set up of systems build, renewal, updates and maintenance of client’s benefits enrollment system.
Receiving and addressing customer chats and e-mails. Providing assistance based on the allowed support reflected on the client’s benefits administrations platform.
Processing of enrollments, changes, terminations, and audits in accordance with the rules set by the clients.
Processing of payrolls, adjustments, enrollments, changes, terminations, and audits in accordance with the rules set by the clients.
Processing of client’s monthly billing invoice based on their run date with 5 days SLA in a monthly basis. Reviewing Member billing audit and monthly invoices generated by the client system making sure everything that is expected to reflect in their invoice will be reflected correctly. Applying adjustment whenever necessary.
Processing of client’s monthly billing invoice based on their run date with 5 days SLA in a monthly basis. Reviewing Member billing audit and monthly invoices generated by the client system making sure everything that is expected to reflect in their invoice will be reflected correctly. Applying adjustment whenever necessary.