Specialist - AAGI A&H Fax Claims

Job description

Is assigned to support Claims Hospital Fax Team. Also handle the fax claims received from hospitals, tracks and monitors to ensure that there is no the pending cases of fax claims, or back log.

1) Hospital Fax Claims
- Provide supports to team in handling the fax claims from the hospital
- Check the information from fax claims documents, and record into the system
- Support team to investigate and make decision for claims in the system, by covering the below actions:
- Approve for the payment base on authorization
- Perform rejection of fax claims received
- Require the additional information
- Issue memo into the system for administration in performing next steps
- Submit for further investigation
- Request the hospital records from hospital
- Continuously monitor and make decision for the pending cases of Claims Hospital Fax , or back log                                                                                                      

Any AI-future skills e.g., ChatGPT, or CoPilot 365, will be an advantage