It is the policy of the FSM Government that qualified FSM citizens is given first priority for employment consideration; with other Micronesian and U.S. citizens utilized in positions for which no qualified FSM citizens are available.
POSITION AND SALARY:
Utilization Claim Reviewer
PL-30/1
$640.45 B/W + $40 Cola = $680.45 B/W
This is the minimum rate at step one of the grade. Higher rates may be authorized in cases of hard-to-fill positions where it is appropriate to the qualification of the appointee.
LOCATION:
FSM MiCare
National Government
Palikir, Pohnpei FM 96941
DUTIES & RESPONSIBILITIES:
Communicates to any members with pending or incomplete document on their claims and further review the document for immediate processing of a claim; Verifies of all claims for member’s eligibility and completion of necessary claim form for review and processing of the claim; Drafts utilization monthly report for the CUO for the Administrator and Management review; Drafts response regarding member inquiries and correspondence; Attend to the inquiries and concerns of MiCare members by answering Phone calls or personal inquiries; Files all medical documents and other important medical data in timely manner; Explains to the members the regulations of the Program including any new changes in the policy, limitation and exclusion clauses in the Plan; Conducts orientation of Plan members and other interested groups or Individuals regarding the program during Open Season; Disseminates of Program information to the members; Process and input medical claims from various providers; Perform other duties as assigned.
QUALIFICATION REQUIREMENTS:
Graduation from an accredited college or university with an Bachelor Degree in Health Science or related field plus two (2) years of work experience in Healthcare, Insurance, or related field.
Secure Application Forms From and Return to FSM National Government Personnel Office
or send your application, resume, along with other credentials to the below email address:
personnel@personnel.gov.fm
