Assistant Officer

We are seeking a highly motivated Assistant Officer – Claims Assessment to join our Claims team. In this role, you will be responsible for supporting the end-to-end process of assessing and processing individual and group medical claims, ensuring accuracy, compliance, and excellent service delivery.

Key Responsibilities :

• Handle claims data entry for both inpatient and outpatient medical claims.
• Review and evaluate claim submissions, ensuring all documentation is complete and valid.
• Verify claims accuracy through cross-checking with relevant medical and policy records.
• Communicate with claimants, healthcare providers, and other stakeholders to gather necessary information or clarification.
• Maintain clear and detailed documentation of claims assessment and decisions.
• Support the Claims Manager in preparing reports and analyzing trends.
• Ensure compliance with internal policies and regulatory guidelines.
• Provide prompt and effective customer service to internal and external stakeholders.
• Mentor and support junior staff as needed.
• Participate in process improvement initiatives to enhance claims processing efficiency.
• Perform ad hoc assignments as directed by management.

Job Requirements :