About the role
Receive, review and validate the submitted hardcopy claims from providers.Assure the completeness of needed documents in compliance with GM Egypt procedures.Compare and validate the NP (Network provider) code stated on the print out bordereaux vs. the provider’s name mentioned on the submitted statement.Adjust the online transactions vs. the hardcopy claims and perform the required adjustments.Add any additional claims adjustments if needed on I*Geme.Report the adjustment reasons on the statements and claims delivery reports.Perform data entry process of claims submitted by the off-line providers.Assure the proper application of I*Care by the providers.Report missing services or items per provider and any tariff mismatching items regularly.Handle the filing and sorting of deductions softcopy for all the healthcare service providers according to their categories.Follow-up on claims reception according to pre-set schedule.Send the adjusted claims to the specified shared folder. Implement proper sorting and filing of claims.
BS degree in information systems, business administration or any related field.Previous experience in data entry or claims processing.Ability to deal with MS Office applications and computer literate.Good command of English language.Target-oriented, hard-working and ability to stick to tight deadlines.Strong Analytical skills, organizational skills with the ability to handle multiple assignments.
