プロバイダークレームリエゾン/ Provider Claims Liaison

A global healthcare services company is seeking a Provider Claims Liaison (Billing and Payments). The selected candidate will manage medical claims, billing records, provider enquiries, payment processing, cross-functional queries, and compliance with data protection requirements.

Responsibilities:

• Receive provider invoices through email, post, and other channels and log invoice information accurately in the Excel tracker
• Review and validate medical claims by verifying billed charges against services authorised in Guarantee of Payment letters
• Record medical claims in the BiGGeR system for timely payment processing
• Handle provider enquiries by email and phone, investigate concerns, and provide timely resolutions professionally
• Work closely with Operations, Medical Benefit Reviewers, Billing, and Network Service teams to resolve queries and outstanding issues
• Maintain effective communication with supervisory and management teams and provide timely updates on matters affecting productivity and efficiency
• Protect private health and personal information by adhering to HIPAA and PCI compliance requirements when handling billing and reimbursement data
• Participate in day-to-day office activities, meetings, and task force groups to support process improvements

Requirements:

• More than 2 years of experience in customer service, medical claims billing, or a related field, preferably in a healthcare or financial sector organisation
• Experience demonstrating customer service skills in the private sector
• Experience in claims or billing
• Proficiency in MS Office Suite
• Comfortable working with financial data
• Ability and willingness to travel minimally, less than 10%
• Native level Japanese; excellent level English

Preferred requirements:

• Further education
• Experience with Electronic Data Interchange (EDI)
• Knowledge of hospital or medical administration
• Possess a valid medical terminology certification

About the Company:

A global health and security services organisation providing medical assistance, travel risk management and emergency support to businesses and their employees worldwide. Employees benefit from career growth, professional development and opportunities within a purpose-driven and internationally connected workplace.

Keywords:

プロバイダークレーム, 医療請求, 保険請求, 請求処理, 医療事務, カスタマーサービス, 支払処理, 医療保険, 保険請求管理, 求人, 外資系

Job Ref: 1H2K00