Officer/Senior Officer, Pre-Authorisation and Minor Claim (Contract)
Core
Assess and handle minor and pre-authorization insurance claims, ensuring compliance with policy terms and medical guidelines.
Role type
Claims Officer (Pre-Authorisation and Minor Claims)
Builds
Approved claims payments and resolutions for minor/pre-auth cases
Domain
Insurance / Health Claims
Deliverable
client delivery
Required skills
Claims assessment, policy compliance, medical guideline interpretation, claims investigation, customer/agent communication, payment processing, document verification
Preferred skills
UAT script review, project participation, maker-checker framework experience
Technologies
None stated
Responsibilities
Handle and assess minor and pre-authorization claims within delegated authority; Perform claims investigation where necessary; Check and sign payment letters and prepare non-standard payment and decline letters; Handle enquiries and complaints from customers, agents, and internal staff; Follow up on additional supporting documents to facilitate claim resolution; Participate in UAT script reviews and ad hoc projects.