Medical Claims Examiner Assistant
vor 4 Wochen
Job Description
The Medical Claims Examiner Assistant is a critical role within the WHO team, responsible for ensuring the accuracy and efficiency of medical claims processing.
- Verify medical claims against established rules and guidelines, collaborating with senior staff to ensure compliance.
- Ensure timely submission of claims, verifying proof of payment and checking for completeness.
- Process daily claims through the SHI Online system, maintaining accurate records and data entry.
- Escalate complex claims to senior staff, requesting medical reports as needed.
- Prepare input documents for computer processing, ensuring seamless claims execution.
Requirements
Education
Essential:
Completion of secondary school education or equivalent
Experience
Essential:
At least 2 years of clerical experience in an administrative/office environment, with a service-oriented focus
Desirable:
- Experience in UN-system health insurance and/or commercial health insurance companies.
- Multicounty/international experience, particularly in WHO and/or other UN Organizations, with expertise in WHO SHI rules, WHO staff rules, and Financial Regulations.
Skills
- Skillful management of workload, prioritizing tasks and handling unusual requests.
- Effective communication, diplomacy, and courtesy when dealing with sensitive healthcare providers and staff.
- Responsible for ensuring confidentiality and handling cases of potential fraud or anomalies.
- Efficient organization of time and priorities, working proactively to avoid loss of time.
- Responsible for maintaining quality and consistency of data entry and ensuring files are complete and organized.
WHO Competencies
- Teamwork
- Respecting and promoting individual and cultural differences
- Communication
Language Skills
Essential:
Expert knowledge of French
Desirable:
Intermediate knowledge of English
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