MME Administrative Assistant

Description

Job Summary: We are seeking a Customer Service Assistant/Hospital Admission Assistant to manage MME claims, resolve incidents, and coordinate with insured individuals and medical providers. Key Highlights: 1. Opportunity to work in a comprehensive healthcare environment. 2. End-to-end management of Major Medical Expenses (MME) claims. 3. Continuous training and an excellent working environment. We are a health services administration company offering customized health plans. **WE ARE LOOKING FOR YOU!!!!!!** Customer Service Assistant/Hospital Admission Assistant for: **Medica Sur Hospital.** **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 decisions. * Preparing final settlement and payment rejection letters for hospitals regarding MME cases. * Resolving and tracking incidents related to insured individuals’ service. * Handling and following up on payment clarifications from network medical providers. * Managing policies, tracking, clinical files, and direct collaboration with physicians. * Responding/rejecting claims. * Scheduling surgeries. * Processing 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 using Windows environments. * Ability to diagnose and resolve problems. * Excellent communication and problem-solving skills. * Completed or incomplete undergraduate degree in Economics/Administration. **We Offer:** * Base salary * Food vouchers * Statutory benefits * Continuous training Excellent working environment * Full-time position * Monday to Friday * Half-day Saturdays Employment type: Full-time Benefits: * Food vouchers Education: * Completed high school diploma (Preferred) Experience: * Administrative activities: 1 year (Preferred) Workplace: On-site employment