Financial Employee Healthcare Claims

Are you precise, analytical, and energized by working with complex data? Do you have an affinity for financial processes and want to contribute to correct and timely claims processing towards health insurers? Then we are looking for you! As a Claims Employee, you are responsible for the correct, complete, and timely processing of claims to health insurers. You ensure that claim files comply with the applicable claim standards and monitor the entire claim process, from creating and sending claims to processing return information and settlements. Additionally, you are the point of contact for internal and external questions about claims and resolve any disputes with health insurers. Your tasks include maintaining claim variants for the claim process, creating and processing, among other things, daily rates and recoveries, and checking the accuracy and completeness of claim files. You identify missing data and coordinate with the appropriate departments. Furthermore, you submit claims to health insurers on time and resolve unsubmitted claims. You process and check return information from health insurers in SAP, administer specifications, additional payments, and settlements, and monitor payments and receipts from health insurers. Finally, you book additional payments, settlements, and bank mutations, resolve disputes with health insurers, and answer questions from internal and external stakeholders about orders, deductibles, claims, returns, and credits. You also prepare reports on the claim process and contribute ideas for improvements within the claim process.