Medical Claims Processor

Analyzes claims and decides whether they are covered by policy. Makes recommendations for the settlement of claims. Informs clients if claims are accepted and how they will be allocated. Organizes payments to clients and repair or replacement of lost items. Makes sure all inquiries and payments are dealt with quickly. Appoints insurance loss adjusters and private investigators when required. Contacts independent experts in case of disputes and attends disputes tribunals. Obtaining approvals for medical procedures. Works closely with insurance companies/TPAs. Communicates and follows up with insurance companies. Explains clients about policy coverage. Any complaint received from DHA to be attended to within one hour on the same day. All reimbursement claims to be submitted after due verification on the same day to insurers. #J-18808-Ljbffr