Healthcare Claims Professional
2 weeks ago
About healthcare claims, we support professionals to serve diverse communities. Our commitment is at the heart of everything we do - driven by values, mission, and people-first culture.
Role SummaryWe are seeking a Hospital Claims Specialist to join our Claims & Business Operations team. This role involves accurately assessing and processing hospital claims in line with rules, policies and procedures while delivering exceptional service to members, providers, and third-party organisations.
Key Responsibilities- Accurately assess claims in accordance with Rules, policies, procedures, and legislative requirements, within service level agreements.
- Handle inbound and outbound calls, ensuring timely, accurate and professional communication with members, providers, and third parties.
- Maintain comprehensive knowledge of systems and products.
- Deliver clear, professional, and respectful written and verbal communication with internal and external stakeholders.
To be successful you will have:
- 3+ years experience in same/similar Senior Hospital Claims Assessor role.
- HSC or equivalent preferred.
- Candidate should have customer service background.
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