Payment & Support (Pipeline )

Job Description

To ensure that all provider payment shall be delivered within timeline with 100% accuracy. and support providers and Provider Relations department to comply with the regulation requirements within the agreed policy and procedural protocols

Payment Types

• Reviewing the GSS(General Summary Statement) & Tax Invoice received from the provider if data presented are correct and no missing data before requesting the agreed payment. Assisting with the implementation of new processes and procedures.
• Submitting all requested payments received within the same day to maintain the 1 day sub KPI payment with 100% quality.
• Ensuring the correct percentage of deduction for providers having a recovery amount.
• Coordinate with Finance and Claims to resolve payment issues
• Ensuring that all initial statements are paid withn the agreed KPI.
• Responsible in checking all pending claims in the system, dummy members against cognos report by amending any claims pending.
• Reviewing all the necessary attachments before ticking settled and generate statement in the batch header maintenance tick box.
• Checking each provider in the list of fraudulent before processing their payment

CHI & NW

• Maintaining Bupa NW compliant to regulator who mandated that provider’s contracts should be terminated once their CHI accreditation has expired.
• Securing the authorized forms for all NW monthly update and maintaining the accurate update through system.

Project Support

• Support Manger during project implantation by providing logistical and planning support.
• Ensure post-implementation benefits realization are reported accurately and on timely manner.

Skills

• Advanced Excell Skills
• Proficiency in English and Arabic (spoken and written)
• Communication Skills
• Negotiation Skills
• Bachelor degree in science majors
• Expert in editing and validating numerical data