Claims Officer

We are seeking a skilled and detail-oriented Medical Claims Officer to join our team. The Medical
Claims Officer will be responsible for performing technical audits on medical claims, evaluating
claims for eligibility, and reviewing claims to ensure that all required information is included. The
ideal candidate should have a strong medical background, be highly organized, detail-oriented,
and possess strong communication and interpersonal skills. They should be able to work
effectively as part of a team and manage a high volume of claims while maintaining a high level
of accuracy and productivity. These activities should adhere to the organization’s agreed policies,
procedures, and guidelines.

Role:-

• Perform technical audits on medical claims and assess their eligibility to ensure that they
meet policy guidelines.
• Review claims to ensure that all required information is included.
• Perform accurate and timely data entry of claim processing.
• Ensure that all claims’ printouts are extracted from the system properly.
• Maintain a high level of accuracy and productivity while meeting established performance
metrics and quality standards.
• Work collaboratively with colleagues in a team environment to achieve shared goals.