Responsible for ensuring proper processing of information from first line of process to identify and reconcile possible adjustments.
Job Scope
Information Review
Processes client information by adheres to the standard operating procedures (SOP) and turnaround time set forth
Reviews and identifies if there are adjustments and variances to reconcile
Summarizes information to prepare necessary reports
Liaises with other processors to reconcile any issues regarding client information
Business Process Support
Resolves issues and other inquiries regarding matters of work in a customer-oriented approach
Ensures proper file management for all client systems by accurate and complete documentation
Routes tasks to appropriate processors by utilizing internal systems
Refers matters beyond limits of authority and expertise to immediate superior for direction
Upholds the Crawford Code of Conduct by protecting the confidentiality of information
Performs variety of administrative duties and other related tasks from time to time as assigned to contribute to other business processes
Non-clinical staff may not conduct any activities that require interpretation of clinical information, including but not limited to, the choosing of a set of criteria to use for handling a request for healthcare services or treatments.
Functional Knowledge
Bachelor’s degree in any related course.
At least two (2) years working experience in a claims or insurance management services.
Proficient typing skills.
Good communication skills.
Proficient in word processing and spreadsheet softwares.
Analytical skills - Identify and evaluate information.
Ability to multi-task, prioritize and manage time effectively.
Keen attention to details in order to produce quality output.
Maintains high degree of professionalism and confidentiality.
Interpersonal skills - Able to work independently and as a team member.