Sachbearbeiter (m/w/d) - ärztliche Versorgung
Core
Process claims and reimbursements for outpatient medical services, verify treatment methods, and decide on benefit obligations for insured members.
Role type
Claims processing specialist (outpatient medical care)
Builds
Reimbursement decisions and service eligibility for outpatient medical treatments
Domain
Health insurance / Social security
Deliverable
client delivery
Required skills
Claims processing, benefit verification, medical service assessment, invoice processing, regulatory compliance
Preferred skills
Experience in statutory health insurance, knowledge of BITMARCK_21c|ng, MS Office proficiency
Responsibilities
Inform and advise insured members on outpatient contractual medical services, process reimbursement applications for non-contractual and special outpatient services, evaluate new examination and treatment methods, process invoices for outpatient medical services outside the global fee, handle applications for additional statutory benefits