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    Medical Claims Officer - Amman, الأردن - ForUs Portal

    ForUs Portal
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    وصف
    • Determines covered medical insurance losses by studying provisions of policy or certificate.
    • Establishes proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, and other insurance companies; initiating or conducting investigation of questionable claims.
    • Documents medical claims actions by completing forms, reports, logs, and records.
    • Resolves medical claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter.
    • Ensures legal compliance by following company policies, procedures, guidelines, as well as state and federal insurance regulations.
    • Maintains quality customer services by following customer service practices; responding to customer inquiries.
    • Provides legal support by assembling documentation for settlement action.
    • Protects operations by keeping claims information confidential.
    • Prepares reports by collecting, analyzing, and summarizing information.
    • Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.
    • Accomplishes organization goals by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.

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