CLAIMS ASSISTANT (2 positions)

Organizational Context

These positions are within the UNSMIS Unit in The Hague, part of the Medical Insurance Section at the United Nations Office at Geneva. The unit falls under the Financial Resources Management Service and the Division of Administration. Incumbents report to the Administrative and Benefits Officer of the Medical Insurance Section.

Job Purpose

The Claims Assistant will process health insurance claims, verifying expenses, benefits, and related costs. This involves validating data in the Medical Insurance Underwriting System (MIUS) and the e-Claims portal. The role requires assisting with complex queries for high-value claims, researching accident-related information, and following up on pending files. Additionally, the assistant will analyze payment discrepancies, reconcile payments, draft responses to insured members, archive claim files, and perform periodic quality checks, all under the supervision of the Administrative and Benefits Officer.

Responsibilities

Process health insurance claims, including checking claims, prior authorizations, and supporting documents, and verifying benefits and costs. Validate expenses, apply accurate reimbursement codes, and effect data validation in the MIUS and e-Claims portal. Respond to complex queries regarding high-value medical claims and requests from various countries. Research information related to staff accidents during official duties or involving third parties. Ensure timely follow-up on pending claim files. Analyze pending payments and claims lists, and assist in checking discrepancy lists and payment reconciliations. Draft responses to insured members, archive medical claim files, and assist with periodical quality checks of medical claims.

Work Experience

A minimum of five years of experience in finance, accounting, or related areas is required. This minimum is reduced to three years for candidates with a first-level university degree or higher. Two years of experience within the UN Common System or a similar international organization is desirable.

Skills

Professionalism, Teamwork, Planning and Organizing, knowledge of international health insurance schemes (desirable).

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