Senior Claims Processing Officer
il y a 1 semaine
Saint George Medical Center is located in the heart of Keserwan region in Mount Lebanon, this medical center overlooking the beautiful valley of Ajaltoun, responds to the pressing need of the healthcare sector and aims to become a state-of-the-art medical institution. Saint George Medical Center is committed to providing high-quality healthcare to the community in an environment of compassion, equity, and continuous development. And aims to be a leading and academically-driven healthcare facility providing individual-centered, comprehensive healthcare.
Job DescriptionSGMC is currently recruiting a Senior Claim Processing Officer
Job Overview:
Seeking a detail-oriented Claim Processing Officer to review, verify and process insurance or medical claims efficiently and accurately. The role involves communication with clients, healthcare providers and internal departments to resolve discrepancies and ensure timely claim settlements.
Key Responsibilities:
- Review, verify, and process medical claims in compliance with insurance policies and hospital guidelines.
- Coordinate with insurance companies/TPAs regarding pending, delayed claims.
- Ensure accurate documentation and timely submission of claims.
- Reconcile claim payments, resolve discrepancies, and follow up on outstanding balances.
- Communicate with internal departments (billing, accounting, medical staff) to resolve claim issues.
- Track claim statuses and maintain updated records in the hospital system.
- Investigate and escalate long-pending or disputed claims when necessary.
- Prepare and share regular reports on claim status, collections, and outstanding amounts.
- Assist in audits and compliance reviews related to claims and billing.
- Support process improvements to enhance efficiency and reduce claim discrepancies.
Job Requirements:
Education & Experience:
- Bachelor's degree in Business Administration, Accounting, Healthcare Management, or related field.
- Preferably two years previous experience in claims processing, billing, or healthcare insurance.
Skills:
- Strong attention to detail and analytical skills.
- Good knowledge of insurance policies, claims procedures, and billing systems.
- Excellent communication and follow-up skills.
- Proficiency in MS Office (Excel, Word).
Interested candidates may submit their resume at: [email protected]
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