MME Administrative Assistant

Description

Job Summary: We are seeking a Customer Service/Hospital Admission Assistant to manage MME claims, resolve incidents, and administer policies at Hospital Medica Sur. Key Highlights: 1. Customer service and management of Major Medical Expenses (MME) claims 2. Direct collaboration with physicians and clinical file tracking 3. Continuous training and an excellent work environment We are a comprehensive health services administration company offering customized health plans. **WE ARE LOOKING FOR YOU!!!!!!** Customer Service/Hospital Admission Assistant for: **Hospital Medica Sur.** **Responsibilities:** * Receiving, processing, and paying MME claims (Reimbursement, Direct Payment, and Scheduled Surgery) * Analyzing cases submitted for payment by insured individuals, resolving issues, and issuing payment determinations. * Preparing final settlement and payment rejection letters for hospitals regarding MME cases. * Resolving and tracking incidents related to insured individuals' service. * Addressing and tracking payment clarifications from medical network providers. * Policy administration, tracking, clinical file management, and direct collaboration with physicians. * Response/Rejection * Surgery scheduling * Reimbursements **Requirements:** * Minimum one year of verifiable work experience in Major Medical Expenses (MME) knowledge (VERIFIABLE) * Basic knowledge of Major Medical Expenses insurance policies. * Practical experience with Windows environments. * Ability to diagnose and resolve problems. * Excellent communication and problem-solving skills. * Completed or incomplete Bachelor's degree in Economics and Administration. **We Offer** * Base salary * Food vouchers * Statutory benefits * Continuous training Excellent work environment * Full-time position * Monday to Friday * Saturday mornings Employment type: Full-time Benefits: * Food vouchers Education: * Completed high school diploma (Desirable) Experience: * Administrative activities: 1 year (Desirable) Work location: On-site employment