Responsibility

Review and validate hospital billing documents to ensure accuracy and completeness.

Assess the appropriateness and correctness of billed expenses in accordance with policy terms.

Analyze policy coverage and insurance limits to determine claim eligibility and ensure compliance with coverage conditions.

Liaise with hospitals and relevant stakeholders to facilitate efficient claim processing.

Evaluate and approve claims in adherence to the established Service Level Agreement (SLA).

Perform additional duties as assigned to support operational efficiency.

Qualification

Bachelor's degree in any field; candidates with at least 3 year of experience as a Claim Assessor, UR Nurse or experience in the insurance industry or nursing knowledge will be given special consideration.

Detail-oriented and responsible for assigned tasks.

Proficient in computer skills, with a strong command of MS Office.

Strong communication skills, ability to work under pressure, service-minded, and highly responsible.

Professional demeanor, excellent interpersonal skills, integrity, diligence, perseverance, and a positive attitude.