About
The Validation Officer typically owns the following key responsibilities to ensure successful and compliant CHI uploads. Issues such as member corrections, CHI rejections, and delayed CHI linking were specifically referenced to member validation and CHI processing.
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Responsibilities
- Verify policy and member mandatory information before uploading onto CHI.
- Ensure National ID, Iqama, Border Number, Passport Number, and Member IDs are accurate and match supporting documents.
- Perform pre-upload validation on additions, deletions, transfers, and corrections to prevent CHI rejections.
- Investigate mismatches between client census files, system records, and CHI requirements.
- Analyze rejection reasons, coordinate corrections, and resubmit records within agreed SLA timelines.
- Confirm policy effective dates, enrollment dates, and renewal dates align with underwriting approval and policy setup.
- Process updates such as DOB corrections, ID changes, relationship changes, and member transfers between groups.
- Track uploaded members until successfully accepted and linked in the CHI portal and escalate unresolved cases promptly.
- Ensure all uploads meet regulatory requirements and internal compliance standards.
- Produce validation error reports, rejection analysis, SLA performance reports, and recommendations to reduce upload failures and improve first-time-right quality.
- Ensure Validation mailbox is reviewed and actioned within SLA.
Qualifications
- Bachelor’s degree in healthcare administration, Business, or related field (or equivalent work experience).
- 1 - 2 years of experience in benefit setup or insurance policy administration within a health insurance company.
- Experience with benefit configuration tools and administrative platforms.
- Familiarity with medical coverages and CHI uploads, eligibility process.
- Knowledge of insurance regulatory requirements (CHI, IA, Nphies).
Skills
- Excellent attention to detail and analytical skills.
- Proficient in MS Office (Excel, Word) and data entry systems.
