Key responsibilities / What you do:

Precertification officer provides quality service to clients, promptly and effectively assesses and processes claims and approvals according to operations set standards.

Assesses approval of medical approvals as well as policy use.

Checks particular treatment plan is necessary for the patient.

Inputs verbal and written claims approvals regularly.

Decides approvals as per policy conditions.

Assesses high cost claims and provides decisions on high cost and complicated cases.

Provides clear feedback on queries from call centre team.

Provides clients an understanding of any declined medical claims.

Coordinates workflow and meets deadlines.

Evaluates claims with regards to eligibility.

AI readiness: Works effectively in an environment shaped by artificial intelligence (AI), machine learning, data, analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use.

Key requirements / What you bring:

Bachelor's of Pharmacy.

2+ years medical practical experience (reputable insurance provider, broker or a TPA experience a plus).

Legally permitted to work in the country of operations.

Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.