Claims Processors

DUTIES AND RESPONSIBILITIES:

• Direct report to Liaison Physician.
• Evaluates and identifies the company’s requirements and makes appropriate recommendations in commensurate with the established policies and procedures.
• Evaluates proposals received from companies for all coverage, conducts analysis, and submits reports with recommendations.
• Receive inpatient cases (PPS/SPS/Regular admission) and ensure that documents are complete and arranged.
• Receive daily finished claims and print company invoices for each claim.
• Submit finished claims to be performed by Liaison Physician.
• Submit requested claims to Physician that require review.
• Receive approved services.
• Receive rejected claims and rework them for resubmission.
• Check billed statements according to requiring confirmation and summarize all statuses of confirmed and rejected claims.
• Maintain communication with Aramco Accounting Office in all matters.
• Comply with the requirements and coverage of the policy provided by Aramco.
• Work on PCP monthly for the payment.
• General supervising in the Claims department.
• Provide personalized coordinated care and support for patients and families.
• Treat people with dignity, compassion, and respect.

QUALIFICATIONS:

• Diploma

PROFESSIONAL EXPERIENCE:

• 0-2 years

SPECIALIZED SKILLS:

• Skills and computer literate.
• Excellent knowledge of oral and written English.