... provider direct settlement networks, provide medical expertise on claims, and report and manage worrisome trends. 1. Handle ... Provide advice for large loss, complex and contested claims and contribute to writing a “Medical Guidelines Manual”. 5. Investigate claims for possible abuse, fraud or medical negligence. 6. Manage the local network of ... 7. Analyse reports to identify trends and improve claims services and costs. 8. Adhere to Best Practice ...

To assess and process claims accurately and consistently. 1. Deliver timely and accurate claims administration services: claims adjudication, data entry, production of claims correspondence such as claims settlements, declinations, information requests, etc. 2. Communicate with ... reports, clarification and additional information to support the claims processes. Investigate claims for possible abuse and fraud. ...

... limited to, the following: Researching billing discrepancies Resubmitting claims to third party carriers, Reviewing transferred claims, Reporting non-payment issues, Contacting clients to update personal information • Entering and uploading details of claims onto program - MedAdvantage • Process medical claims • Answering queries using telephone/fax/ emails. • Use ...

Job Duties: • Processing claims · Running paper work/summary of benefits for each claim processed · Handling and sorting queries regarding claims via telephone/email and fax. • Internal coordination with various departments. • Use Excel spreadsheets for reporting • Any other duties assigned by the Head of Department The successful ...

Service existing marine business, including claims arising from the business. Analytical and presentation skills, broking skills, claims handling skills, MS office computer package skills, tactful and cultural awareness. Sound knowledge of marine market and marine insurance products. Ability to motivate and to convey in ...