The National Health Insurance invites qualified and professional applicants to apply for the post of Claims Processor .
The Claims Processor is tasked with efficiently reviewing, processing, and verifying claims to guarantee accurate and timely payments. This role demands attention to detail, strong analytical skills, and effective communication abilities. The Claims Processor is essential in upholding the integrity of the claims process and ensuring adherence to organizational policies.
Major Responsibilities
- Review and verify claim forms to ensure completeness and accuracy.
- Logs in and and edits claims via the Claims Editor and Claims payment system.
- Follows up with with claimants to verify the accuracy and completeness of information to be included in the claim forms.
- Process benefits claims, including assigning claim numbers for new claims and gathering supporting documentation to facilitate timely and accurate payments.
- Investigates the validity and authenticity of medical claims received, as necessary.
- Prepare payment checks and corresponding documents for distribution as part of the claims reimbursement process.
- Scan and upload claim images and supporting documents to the NHI database in a timely and organized manner.
- Prepare detailed weekly reports and statistics on claims received, processed, and outstanding.
- Respond to and resolve inquiries related to claims, escalating complex issues to the Claims Supervisor when necessary.
- Approve claims in accordance with company policies and in consultation with the Claims Supervisor.
Requirements of the position:
A) Education
Required Education: Associate’s Degree
PLUS
Field of study: Medical Coding or health care related field (preferred)
Work Experience: Minimum of 1-2 years in related field
Certifications/Licenses Required: Medical Coder is a plus
B) Knowledge, Skills & Abilities
- Sound knowledge of the regulations governing the VISSB/NHI.
- Working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook).
- Strong written and verbal communication skills.
- Strong analytical and problem-solving skills with a focus on accuracy and efficiency in processing claims.
- Ability to work collaboratively within a team while also handling independent responsibilities.
- Attention to detail and commitment to excellence demonstrated by the delivery of quality and timely outcomes.
Application Reference # – NHI-2025-Ext-003
or
Please send Resume/CV, cover letter and (two) 2 professional references to the:
Human Resources Manager
Social Security Board
P.O. Box 698
Road Town, Tortola
Virgin Islands
VG1110
[email protected]
Closing Date: May 9th, 2025
