Claims Process Executive – WARBA Insurance
Role Title: Claims Process Executive
Role purpose summary: Pre-approval and Claims processing
Key Responsibilities and Accountabilities:
- Data Entry in the system
- Responsible for screening all the Preapprovals including in-patient cases.
- Take decisions based on policy wordings, coverage, limits, necessity and correctness of the service codes.
- Medical reports analysis and assessment.
- Providing a medico-legal justification elements for the rejected or partially approved cases.
- Handling the calls of the Preapprovals and medical queries.
- Capturing the details of the invoice (Member Name, Policy Number, Group Name, Received Date, Lot Number, Invoices) into the system.
- Auditing the system adjudication with the benefits and the amounts claimed
- Comparison with Provider Statement (For Direct Billing Claims).
- Updating the Team Leader with the progress report.
- Achieve the targets put up by the Team leader
|Job Location:||Al Kuwait, Kuwait|
|Job Role:||Support Services|
|Career Level:||Mid Career|