The Claims Management – Tracking Officer is responsible for monitoring all Direct Claims received from providers in line with Nextcare standards. This role ensures that Nextcare’s operational standards are met with maximum productivity and efficienc
Key responsibilities/What you do:
- Regularly review and track claims from providers, including these key duties:
- Verify claim submissions for completeness.
- Confirm adherence to the required submission formats, such as general and detailed statements of account.
- Perform initial checks comparing the count of physical claims received against the statement.
- Provide timely feedback for corrections, missing information, or format discrepancies.
- Organize received claims into batches according to standards and deliver physical claims to the Retrospective team.
- Maintain accurate documentation, feedback, and endorsements for the following:
- Communicate directly with providers if claims lack information or do not follow submission standards; if unreachable, escalate to provider OPS for support.
- Return claims with incomplete administrative details to the provider.
- Direct providers not registered on TATSH to the MPM team for setup
Key requirements/What you bring:
- Bachelor’s Degree.
- 0 to 2 years of management experience preferred in the Healthcare Industry (TPA, insurance companies, hospitals, medical centers, or pharmacies).
- Physically capable of performing assigned duties.
- Legal authorization to work in the country of operation.
- Proficiency in MS Office (Excel, Word, Outlook, PowerPoint) and strong internet navigation and research skills.
- What we offer:
- Our employees are vital to our success, and we value each individual’s unique needs and ambitions, supporting their personal and professional growth.
- We empower you to take charge of your development through a wide range of courses and targeted programs, all within a global environment that encourages international mobility and career advancement.
- We prioritize your health and wellbeing by offering Work Well programs that promote peace of mind and provide flexibility to help you achieve a better work-life balance.
