Your role as a Business Support Executive (Claims) is to ensure accurate and timely submission of clinic claims and reconciliation of payment from the insurance companies.
To provide administrative and billing support to the patient, facilitate the smooth running of the clinic environment, and support the delivery of quality patient care.
Job Responsibilities
Claims Submission
• Managing patient’s insurance claims [e.g. enquiries, documentation, verifying patient’s eligibility and coverage for procedures/ treatments, obtaining pre-authorizations and letter of guarantee (LOG)
• Ensuring the completeness of bills and relevant insurance forms and supporting documents for local and global insurance
• Preparing, reviewing, and transmitting claims using the claim portal, including electronic and paper claim processing
Claims Management & Accounts Receivables
• Following up with insurance companies on unpaid claims, discrepancies in payment, appeals, and resubmissions (where needed)
• Following up with patients to facilitate billing, co-payment & deductibles, and closure of claims, and maintaining an effective recording system
• Reconciling all payments and transactions for the day
• Handling patient feedback: including escalation where needed
• Processing offline payment and communications with patients/ payees for payment
• Ad-hoc duties as assigned
Skills and Abilities
• Diploma or Degree holders with at least two years’ experience in the healthcare, insurance, or hospitality industry
• Proven experience as a Claim Specialist or similar role handling insurance or medical claims/ case assessment
• Pleasant and confident disposition and excellent customer service orientation
• Exceptional written and oral communication skills
• Meticulous with the ability to multitask and stay organized
• Ability to independently follow clinic procedures and job instructions and use good judgment in determining when assistance is needed
• Experience in Plato (clinical software) will be an advantage
• Computer literacy and good analytical skills
• High empathy with a passion for patient care
Working Hours
- Monday to Friday: 9 AM to 6 PM
- Saturday: 9 AM to 1 PM (Alternate)
