RESPONSIBILITY:
Handle pre-certification of out-patient, day-patient and in-patient treatments, employing appropriate cost-management measures, including prospective and concurrent Utilization reviews; Liaise with doctors and providers to obtain medical information; Handle medical evacuation; Investigate claims for possible abuse, fraud or medical negligence; Manage the local network of providers and their contracts; Analyze reports to identify trends and improve claims services and costs;
REQUIREMENTS:
Minimum 3 years experience in medical insurance field;
Proven track record in successfully negotiating with Provider Network members; Excellent command of written and spoken (English); Independent, organized, hard-working and attention to details;
Service driven, team player;
Good computer skills including MS Word & Excel
Our client offers excellent career prospects to the right candidates. Salary will be commensurate with qualifications and experience. Their attractive remuneration package includes:
Comprehensive medical benefits and company holidays 5 days work Variable bonus
Interested Applicants please send your resume (in Word format) together with present and expected salary to Erwin De Smet:
Tel: (852) 2521-5118 ext.824
Email: erwin.desmet@pplesearch.com
** For more job opportunities, please visit our website: www.pplesearch.com **
