Medical Claims Specialist - Mandarin Speaker

About The Role

Process authorized inpatient & outpatient claims transactions within the required benchmarks.

• Process all Inpatient, Outpatient claims and pre-approval requests received as per stipulated requirements
• Ensure meeting individual quality, turn around time and productivity benchmark
• Review/approve cases that exceeds subordinates’ authority
• Respond to email enquiries from internal and external parties
• Perform outbound call to customers when required
• Training of new joiners on claims processing rules and products knowledge including Review and Feedback for On-The-Job training cases
• Providing training in System Navigation and Processing Steps, towards certification with Claims Approval Authority, as stipulated in the Claims Approval Authority guidelines.
• Conduct regular claims review in claims performance to ensure claims principles/authorities are adhered to. Review claims decis...