Announcing the vacancy of  Data Processor – Processing KSA – NEXtCARE EGYPT.

This position reports to the Processing Supervisor – Egypt.

The role encompasses Ensure that insurance claims information is entered into the system correctly, to ensure accurate processing and timely payment plus ensuring that provider’s fees and service items charges coincide with their existing contract price list with NEXtCARE. Ensure the accuracy of the entered data as per the existing standard steps and procedures of direct claims processing, and compare data on claims applications, screen claim documents and process claim adjustment.

Please check the below Duties and responsibilities , plus The Required Knowledge, Abilities, and Skills & The Minimum Requirements.

Scope of Duties and Responsibilities

Primary Responsibility

• Ensure that insurance claims information is entered into the system correctly, to ensure accurate processing and timely payment.
• Ensure that provider’s fees and service items charges coincide with their existing contract price list with NEXtCARE.
• Ensure the accuracy of the entered data as per the existing standard steps and procedures of direct claims processing.
• Compare data on claims applications.
• Screen claim documents and process claim adjustment.
• Ensure Payment Orders are properly created and forwarded accordingly for final documentation and filing.
• Ensure adaptability in various work-related tasks to be able to facilitate a multi-tasking role.
• Ensure that high quality standard of work performance is achieved at all times.

Filing/Monitoring

• May stand as a reference person for information on inquiries concerning claims processing procedures.
• Monitor correct application of beneficiary share accordingly on service items billed.
• Make sure that claims are properly audited of all data entered with accurate medical claims details.
• Note all discrepancies during the course of the system process are properly forwarded and notified to immediate supervisors.
• Provide requisition of office supplies for Individual and Team requirement.

Other Duties

• Research claims as needed
• Obtain and audit medical records to compute and record patient charges.
• Perform other related duties incidental to the work described herein.

Required Knowledge, Abilities, and Skills

• Attention to detail and ability of multi-task
• Organizational & time management skills.
• Ability to meet tight deadlines.
• Ability to work under pressure to tight deadlines
• Strong communication skills.
• Ability to work well with all levels of internal management and staff, as well as outside clients and users.
• Ability to demonstrate sounds work ethics.
• Show flexibility with excellent interpersonal skills.

Minimum Requirements

• Relevant University Degree (preferably medical background , Science , Veterinary , Pharmacist )
• 0-2 years filing/documentation experience. Experience within the Health Care Industry, TPA’s, insurance companies, Hospitals, Medical Centers is a plus.
• Demonstrate commitment to produce output base results.
• Excellent team player.
• Flexible to work in shifting schedule.
• Fluency in Microsoft Office applications (including Word, Access, power Point & Excel), Outlook, and general Internet and research skills Show flexibility, excellent interpersonal skills, project coordination experience.

Please send to me your Resume’ on Mohammad.mahmoud@nextcarehealth.com.