Health Insurance Contract and Claims Officer
Core
Managing and administering contracts and claims for HMO and international health insurance schemes, acting as a liaison between the organization, insurers, and patients.
Role type
Health Insurance Contract and Claims Officer
Builds
HMO and international health insurance coverage and claims processing workflows
Domain
Healthcare / Health Insurance
Deliverable
client delivery
Required skills
Contract negotiation, Claims processing, Regulatory compliance, Risk analysis, Data analysis, Cost management
Preferred skills
Healthcare sector experience, PMP/ACA/ACCA certification
Technologies
Spreadsheets, Databases, Claims management software
Responsibilities
Negotiate and manage HMO and international insurer contracts, Oversee claims processing and resolve disputes, Monitor claim trends and generate performance reports, Implement cost containment strategies, Ensure compliance with healthcare regulations and insurance laws
Seniority
Mid-level, hands-on IC
