Job Description
Qualification:
. Can speak and understand Chinese/ Mandarin language.
. Must be technically savvy with the ability to toggle between multiple applications and/ or computer monitor simultaneously.
. Proficiency with MS Office applications are required (Word, outlook).
. Strong written communication skills.
. Demonstrated analytical and basic math skills.
Duties
. Determine customer eligibility by reviewing contractual language and medical documentation, interpret information and make decisions based on facts presented.
. Assess medical appropriateness of claims submitted and adjust claims as needed.
. Pay all covered claims accurately and timely.
. Execute on all client and provider SLA agreements.
. Manage both new claims and open claims equally and maintains decision turnaround times.
. Understands Client Operations and Corporate Compliance, Policies and Procedures and best practices.