Company Overview

Midas Health Services is a leading healthcare Information system solution provider in Nepal. Our system solution sustains and enhances healthcare services in Nepal. It’s backed by over 20 years of experienced team members, many of whom are expert domain consultants and accomplished professionals with extensive work experience in healthcare ERP system solutions.

Position Summary

As a Medi Claim Processing Associate you will be responsible for overseeing the efficient implementation of medical claim processes and systems within our organization. The ideal candidate will have a strong background in healthcare administration, insurance claims processing, and system implementation.

Key Responibilities: 

1. Manage end-to-end processing of medical claims, ensuring accuracy, compliance, and timely resolution.
2. Collaborate with healthcare providers, insurance companies, and internal teams to facilitate smooth claim submissions and approvals.
3. Stay updated on industry regulations and standards to ensure compliance with healthcare laws.
4. Lead the planning and execution of new system implementations
5. Collaborate with IT teams, vendors, and other stakeholders to define system requirements and specifications.
6. Conduct system testing, and troubleshooting, and provide training to end-users to ensure a seamless transition to new systems.
7. Oversee the collection, analysis, and management of data related to medical claims and system performance.
8. Implement strategies for data quality improvement and ensure the confidentiality and integrity of sensitive healthcare information.
9. implement quality assurance protocols for both medical claim processing and system functionality.
10. Maintain accurate and up-to-date documentation of processes, procedures, and system configurations.
11. Generate regular reports on claim processing metrics, system performance, and compliance status for management review.