Claims Supervisor

Key responsibilities

• Check availability and accuracy of claims details in MAS and make necessary corrections
• Verify unlisted claims in MAS with biller and Call Center
• Process and analyze claims using prescribed process and based on existing policy contract and guidelines
• Prepare transmittal of claims for payment
• Approve payment for claims within authority limit and recommend approval of claims payment beyond authority limit
• Reconcile claims with providers and accounts
• Conduct UAT of system enhancements and provide analysis and findings
• Answer inquiries via email or phone regarding status of claims or overdue payments within set turn-around time
• Document medical claims disputes or complaints and resolve or escalate within TAT
• Reconcile statement of account (SOA) sent by providers and coordinate with concerned departments

About you

• College graduate with a degree in any medical or business-related discipline
• At least 5 years experience in medical or life claims processing
• At least 2 - 3 years experience at supervisory level
• Preferably passed Life Office Management Association (LOMA) courses