Sr. Specialist - A&H Fax Claims

Job Role :

Assigned to support Claims Hospital Fax Team. Also handle the fax claims received from hospitals, tracks and monitors to ensure that there is no the pending cases of fax claims, or back log.

Job Responsibilities :

• Provide support to the team in handling hospital fax claims.
• Review information from fax claim documents and record it into the system.
• Assist the team in investigating and making decisions on claims in the system by performing the following actions:
• Approve payments based on authorization.
• Reject invalid fax claims.
• Request additional information when necessary.
• Issue memos in the system to guide administrative next steps.
• Submit claims for further investigation.
• Request hospital records directly from the hospital.
• Continuously monitor pending hospital fax claims and backlog cases, ensuring timely decisions are made.

Qualifications :

• Bachelor degree in Nursing Science
• 5 years of working experience
• Any AI-future skills e.g., ChatGPT, or CoPilot 365, will be an advantage.