Financial Claims Coordinator- PMO

"

• Serve as the primary point of contact for claimants, clients, and internal stakeholders regarding claim inquiries and resolution.


• Receive, review, and process financial claims submitted by clients, customers, or third-party entities.


• Verify the accuracy and completeness of claim documentation and supporting evidence.


• Analyze claims to determine eligibility, coverage, and appropriate reimbursement amounts.


• Maintain organized records of all claims, correspondence, and related documentation


• Generate reports on claim status, trends, and outcomes as required by management or regulatory bodies.


• Communicate with insurance providers, healthcare professionals, legal counsel, and other relevant parties to gather information and facilitate claim resolution.


• Collaborate with cross-functional teams such as finance, legal, and customer service to address complex claims issues and ensure timely resolution.


• Conduct audits and quality checks on claims processing activities to identify errors, discrepancies, or potential fraud.


• Ensure adherence to company policies, procedures, and regulatory guidelines governing claims processing and reimbursement.


• Stay updated on changes in regulations, industry standards, and best practices related to financial claims management.


• Resolve disputes or conflicts related to claim decisions through effective negotiation and problem-solving skills.

"

Skills

Qualification Requirement

"Bachelor's degree in Finance, Accounting, Business Administration, or related field.

Prior experience in claims processing, insurance, finance, or a related industry preferred.

Strong attention to detail and analytical skills.

Proficiency in Microsoft Office Suite and claims management software.

Knowledge of relevant regulations and compliance standards