JOB DETAILS:
Job Description
The Medical Claims Manager is responsible for overseeing the entire claims management process within the medical insurance division. This role ensures that all claims are processed efficiently and accurately, aligning with both regulatory standards and the company’s corporate objectives. The ideal candidate will leverage their in-depth knowledge of medical and clinical operations, insurance practices, and service provider management to deliver exceptional service to customers and maintain robust relationships with healthcare providers. They will also play a critical role in fraud prevention and cost control, ultimately contributing to the financial health and reputation of the company.
• Constant monitoring and improvement of claims processes and procedures to ensure compliance with Quality Operating Procedures (QOP) and ISO 9001 standards.
• Delivery of high-quality, timely service to customers while maintaining…
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