Claims fulfillment consultant

Job Description

Claims Processing

The following directly centers around which your daily obligations revolve:

Authorize claims within the set mandate and resolve all claims within the agreed productivity targets and turnaround times by utilizing the claims diary system effectively. Apply and effectively communicate technical skills and resolve all technical issues using available tools and systems. Demonstrate a clear understanding and execution of customer complaints and resolutions that must be maintained and exceeded, as well as a clear understanding of claim rejections. Demonstrate a clear understanding of the management of claims handling that must be followed within the regulated agreements as specified by the relevant regulatory boards. Ensure a clear understanding of all payments, the correct application of rates to be authorized to the service provider, and the correct appointment of service providers to the claims. Demonstrate a thorough understanding of the repor...