Responsible for assess all incoming claims type. Being a consultant and mentor for lower authority assessor in the referred case.
Monitor the health & PA claims processed by the third party admin company to ensure their payment meet our rule & regulation and prevent fraud claims.
Audit claim payment by other claims assessors to ensure the accuracy and appropriate decision making of claims payment.
Maintain the procedure and process to be aligning with contract provision and comply with company and regulator’s rules & guideline.
Deliver regular responsible reports to every receiver on time.