The Claims Process Owner at PPO Serve plays a crucial role in managing the claims process from start to finish. This position requires strong analytical skills and attention to detail, making it ideal for someone with a background in business analysis or claims management.
collaborative and innovative
As the Claims Process Owner at PPO Serve, you will take charge of the entire claims process, ensuring everything runs smoothly from data receipt to payments. Your role will involve overseeing automated systems, maintaining data integrity, and ensuring that all claims are processed accurately and on time. You will be the main point of contact for all claims-related queries, working closely with various stakeholders including finance, operations, and external partners.
Your daily responsibilities will include auditing automated claims pipelines, managing timelines, and performing quality control checks on membership files. You will also be involved in identifying areas for process improvement and supporting the migration of claims processes to a more optimized data platform. This role is perfect for someone who enjoys problem-solving and has a keen eye for detail.
To succeed in this role, you should have a business-related degree and at least five years of experience in a similar field, preferably within a medical scheme or healthcare funding environment. Strong skills in process management, data analysis, and stakeholder communication are essential. Familiarity with tools like Excel and Power BI will be beneficial.
PPO Serve offers a supportive and innovative work environment, where you can make a real impact on healthcare challenges. With opportunities for professional growth and a commitment to work-life balance, this role is ideal for someone looking to advance their career in a meaningful way.
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