Dental Department Claims Processor (M/F) - 1 Year Fixed Term Contract - Luxembourg

You will be part of the "Dental" department. You will help shape the CMCM's brand image and maintain direct, interactions with members. Your responsibilities: In the initial phase, the training programs listed below will focus on processing domestic cases to ensure a solid grasp of the fundamentals. Subsequently, the training will be expanded to include the processing of international cases to round out the expertise: 1. Administrative tasks related to billing when processing reimbursements for customer and third-party payer invoices: Verification of members' personal data (membership number, mailing address, paid membership, waiting period, co-member status, etc.) to determine potential coverage Analysis of medical fee statements submitted by members or third-party payers Search for the codes and rates of procedures applicable for reimbursement Entering data transferred to the CMCM regarding procedures performed by dentists into the software Creation of the claim file and calculation of the reimbursement amount for the member in the CMCM software Final review of the documents in the files before issuing payment orders Filing appeals with the CNS or an other health insurance provider Preparing denial notices in cases of non-reimbursement 2. Communicating with members, doctors, health insurances, and hospitals (by phone, mail, email, and apps) to provide advice, information, explanations, etc. 3. In-person assistance for members in consultation rooms Technical Skills: Excellent oral and written proficiency in Luxembourgish, French, German, and English Interpersonal and communication skills Proficiency in analytical and mathematical skills Proficiency in standard computer software Knowledge of the healthcare sector and of various healthcare and social security systems is considered an asset Behavioral Skills: Organizational s...

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