Claims Receiving and Submission Officer

Key Responsibilities

• Validate healthcare claims through DOH / DHA portals
• Prepare pre-submission and post-submission reports
• Submit eClaims within defined timelines
• Identify and resolve claim errors before submission
• Coordinate with Coding, Billing, IT, DE and Onsite teams
• Verify claim numbers, amounts and submission status
• Handle hard-copy and email-based claim submissions when required
• Raise and coordinate CQM queries with internal teams and clients
• Perform bulk eligibility verification
• Create insurance/TPA packages based on payer and network requirements
• Add or update clinician licenses in DOH/DHA portals
• Maintain submission reference files and reconciliation reports
• Track and report monthly claim volumes and submission values
• Ensure timely and accurate claim submission as per client and payer SLAs

Job Requirements

• 3+ years of experience in a similar healthcare RCM/claims submission role
• Diploma or Bachelors Degree
• Good understanding of Healthcare Revenue Cycle Management
• Experience with DOH / DHA portals is preferred
• Good knowledge and hands on experience in MS Excel
• Strong attention to detail and accuracy
• Good communication and coordination skills
• Ability to work independently with limited supervision
• Comfortable working in a fast-paced environment
• Willingness to work in shifts