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Job Description
At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.
Sound like you? Then read on.
About the Role
Ensure claims are adjudicated accurately and in a timely manner by establishing the validity of loss through assessment of medical documentation & assembling additional information as required.Roles & Responsibilities:
Ensure completeness ofClaims/ Guarantee Letter Pre-certifydocumentsin compliance to Company’s requirements and guidelines
Adjudicatemedical claims byfollowing theorganizationguidelines & within the assignedauthoritylimit.
Establish covered medical insurance losses againstbenefitscoverage and eligibility.
Establish proof of loss by studying medical documentation; assemblingadditionalinformation asrequiredfrom other sources, such as claimant history, physician, employer, hospital details, type of medication, procedures & etc....