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CLAIM EXECUTIVE
Salary undisclosed
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Original
Simplified
1. Verify and process hospital and/or GP claims within 3-5 days according to the client’s schedule of benefits. 2. Ensure documentation in DMS is complete and compliant. 3. Process reimbursement claims within 5-7 working days. 4. Investigate and resolve client/clinic/hospital queries from all communication channels (WhatsApp/calls/emails). 5. Issue Credit Notes (CN) and Debit Notes (DN). 6. Liaise with night shift staff for outstanding tasks. 7. Prepare and arrange for the delivery of hospital bills and claim invoices for dispatch. 8. Update clinics on the status of rejected claims. 9. Ensure claims are ready for invoicing as per the client’s invoice cycle. 10. Check patient entitlement on a monthly basis. 11. Verify claim amounts in the system to identify negative entitlement, duplicates, or claims that are not covered by entitlement.