Claims Management Tracking Officer Nextcare Egypt

What you do:

• Consistently checks and tracks claims received from providers which includes the following responsibilities:
  • Checks claim submission for proper completion.
  • Ensures that standard format for submission is followed such as general statement of account and detailed statement of account.
  • Adheres to initial check of received physical claims count VS the listed in the statement
  • Ensures feedback within set specified time for any corrections, missing information, and any standard format not being followed.
  • Batching the received claims as per our standards and hand over physical claims to Retrospective team.
• Ensures proper documentation, feedback, and endorsement on the following:
  • In case of missing information on the claim and standard format of submission are not followed, tries to communicate directly with the provider and if not reached report the case to provider OPS asking for support.
  • Claims with incomplete administrative information to be returned to the provider.
  • Providers not created on TATSH to be directed to MPM team for creation.