As TPA and Provider Management each day, you'll be…
- Case management of complex high value cases.
- Recommendation on claim decision.
- Medical claim analysis for Statistical report purpose.
- Aggressive cost containment through tight adjudication.
- Partner with hospitals and clinics, negotiate tariffs/discounts, and handle contract renewals.
- Monitor external TPAs to ensure they process approvals and claims quickly and follow company rules.
- Resolve billing disputes and issues between hospitals, TPAs, and the insurance company.
- Review medical billing trends to help minimize unnecessary claim costs.
Requirements:
- Doctor (General Practitioner), with 24 hours on call availability.
- Have experience in Insurance, or Assistance Company related industry with minimum 2 years.
- Computer skill: excel, Power point, Word.
- Well organized, able to work independently, able to manage team.
Skills Required
- Doctor (General Practitioner)
- 24 hours on-call availability
- Minimum 2 years experience in Insurance or Assistance Company related industry
- Computer skills: Excel, PowerPoint, Word
- Well organized, able to work independently, able to manage a team
What We Do
sunday turns the tedious 15 minutes it takes to pay at a restaurant into a quick, simple experience that takes less than 10 seconds. You scan a QR code, pay, and walk away. In the meantime restaurateurs can focus on what matters for them: cooking incredible food and delivering an amazing guest experience. Founded by Victor Lugger and Tigrane Seydoux, the entrepreneurs and foodies behind Big Mamma, and Christine de Wendel. We are based in Paris, London, Madrid & Atlanta. We recruit food & tech enthusiasts. Our 3 values mean this: Simple - building powerful solutions through intuitive design Trust - transparent and accountable in everything we do Beyond - a collective journey, boldly driven by fearlessness
