
DB Claims Specialist
1 day ago
Job Summary
We are seeking a skilled DB Claims Executive to join our team. The ideal candidate will have excellent communication skills, a medical education degree, and experience in claims processing.
Key Responsibilities
• Team Management: The successful candidate will oversee the team in both claims processing and communication, providing guidance and support to team members.
• Claims Processing: They will be involved in the processing of direct billing claims, reviewing complex or high-value claims, and taking decisions on claims settlements.
• Communications: The DB Claims Executive will communicate with providers and other departments through emails and phone calls, including claims registration, escalations, and handling provider queries.
• Training and Development: They will be involved in the training of new team members and providing ongoing training to existing staff, preparing training materials and providing feedback and coaching.
• Performance Monitoring: The DB Claims Executive will track and monitor the performance of the direct billing claims team, providing feedback to team members and identifying areas for improvement.
• Process Improvement: They will identify opportunities to streamline processes, enhance efficiency, and reduce errors or delays in claim processing.
• Reporting and Analysis: The DB Claims Executive will prepare reports and analyze data related to the team's performance and claim trends, providing regular updates to their line manager.
• Compliance and Quality Assurance: They will ensure compliance with all applicable laws, regulations, and industry standards, conducting quality assurance audits and internal reviews.
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