Who We’re Looking For**

Essential Knowledge/Skills and Experience Required:**

• Bachelor’s degree in a related field or a Diploma in Nursing / Diploma in Clinical Medicine. 

• Minimum of 3 years of relevant experience. 

• Registered Nursing, Diploma – Required  

• Excellent communication and presentation skills 

• Vet in/outpatient medical bills/invoices and refer any suspicious claims to the supervisor; 

• Batch outpatient invoices on the system and adjust amount payable as per the vetting findings; 

• Check and reject incomplete invoices and return with supporting documents to service providers. 

• Negotiate, adjust and update service providers on their costs and accounts status;  

• Reconcile statements of accounts for service providers; advising accounts and service providers on unpaid/underpaid bills; 

• Review claims reserves on a continuous basis in view of new developments;  

• Attend to customer queries and complaints promptly and professionally and 

• Recommend risk improvement measures to the underwriter to take appropriate action.