Claims and Payments Assurance Officer
2 weeks ago
Job Summary:
We are seeking an experienced Claims and Payments Assurance Officer to join our team. This role will involve engaging with providers and participants to support assurance testing activities.
Key Responsibilities include:
- Undertaking control and conformance testing of payment programs.
- Providing input to assurance and compliance reports.
- Modifying test documentation to ensure relevance.
- Reviewing targeted claims through engagement with providers, plan managers and participants.
- Contribute to the design of new controls using manual validation checks and systematic analytics.
- Working with teams to investigate, report on and escalate claims and payment anomalies.
Requirements for Success:
- Previous experience in a similar role.
- Ability to work autonomously, exercising strong initiative and judgment.
- Sound communication skills.
- Effective time management and resource allocation.
- Adaptability and change management.
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