Claims & Office Services Manager Heilungskosten (80-100%)
Core
Reviewing and approving/rejecting outpatient medical expense claims (UVG/VVG) for B2B insurance policies based on medical causality, tariff rules, and coverage terms.
Role type
Claims & Office Services Manager (Medical Expenses)
Builds
Approved medical expense payments for B2B corporate insurance clients
Domain
B2B Insurance / Health & Accident Insurance
Deliverable
client delivery
Required skills
Reviewing outpatient medical expense claims, knowledge of medical causality, knowledge of tariff rules (TARDOC), knowledge of coverage terms, coordinating with healthcare providers, communicating with policyholders and brokers, using MS Office (Word, Excel)
Preferred skills
Knowledge of inpatient claims, fluency in French, Italian, or English
Responsibilities
Reviewing UVG outpatient medical expense claims for medical causality and tariff compliance, reviewing VVG outpatient medical expense claims for coverage and liability, coordinating with hospitals and doctors, communicating with insured persons and brokers
Seniority
Mid-level, hands-on IC
