Bessie works as an Admin Assistant in KP Solutions Pte Ltd (KPS), an SME that provides...
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Bessie works as an Admin Assistant in KP Solutions Pte Ltd (KPS"), an SME that provides ERP implementation and consultancy services to their clients. Bessie is responsible for processing medical claims from the employees of KPS before payment. The medical claims are submitted via an online Staff Portal. Every morning Bessie will log on to the Staff Portal via her login as claim administrator. She will retrieve a list of unprocessed submitted medical claims. She will click on each of the online medical claim form to look at the details and attachments. If the claim does not have any attachment (e.g. receipt), the claim will be rejected and retumed to the staff. Next, she will verify the claim by matching against the attached receipt. In particular, she will check if the medical reimbursement is permitted per SOP (e.g. medical claims like cosmetic surgery, LASIK, etc. are not permitted and therefore rejected), and if the amount tallies with the receipt. If there is a discrepancy between the claimed and receipt amounts, she will correct the amount to be claimed. However, if the discrepancy is more than $20, the claim will be retumed to the staff for correction and resubmitted. Occasionally, Bessie will need to call or email the staff for clarifications. Once verified, the medical claims will be saved in the system for review and approval by Flo, the Finance Manager, before reimbursement. On a weekly basis, Flo will login to the same system as Finance Manager, and review each claim, in particular those claims that were amended by Bessie. If there are any issues, Flo will mark these as "pending"status and route these claims back to Bessie for further information or clarifications. Approved medical claims will be processed by the Finance team. Bessie also received the hardcopies of the claims from staff and she will file these into an arch file by sequence of Staff ID. Due to shortage of staff, she does not cross-verify these against those previously received in the system. Illustrate with a standard flowchart of not more than 2 pages to depict the medical claims reimbursement process undertaken by Bessie and Flo as described above. Any reasonable assumptions made should be stated as part of your answers accordingly. Bessie works as an Admin Assistant in KP Solutions Pte Ltd (KPS"), an SME that provides ERP implementation and consultancy services to their clients. Bessie is responsible for processing medical claims from the employees of KPS before payment. The medical claims are submitted via an online Staff Portal. Every morning Bessie will log on to the Staff Portal via her login as claim administrator. She will retrieve a list of unprocessed submitted medical claims. She will click on each of the online medical claim form to look at the details and attachments. If the claim does not have any attachment (e.g. receipt), the claim will be rejected and retumed to the staff. Next, she will verify the claim by matching against the attached receipt. In particular, she will check if the medical reimbursement is permitted per SOP (e.g. medical claims like cosmetic surgery, LASIK, etc. are not permitted and therefore rejected), and if the amount tallies with the receipt. If there is a discrepancy between the claimed and receipt amounts, she will correct the amount to be claimed. However, if the discrepancy is more than $20, the claim will be retumed to the staff for correction and resubmitted. Occasionally, Bessie will need to call or email the staff for clarifications. Once verified, the medical claims will be saved in the system for review and approval by Flo, the Finance Manager, before reimbursement. On a weekly basis, Flo will login to the same system as Finance Manager, and review each claim, in particular those claims that were amended by Bessie. If there are any issues, Flo will mark these as "pending"status and route these claims back to Bessie for further information or clarifications. Approved medical claims will be processed by the Finance team. Bessie also received the hardcopies of the claims from staff and she will file these into an arch file by sequence of Staff ID. Due to shortage of staff, she does not cross-verify these against those previously received in the system. Illustrate with a standard flowchart of not more than 2 pages to depict the medical claims reimbursement process undertaken by Bessie and Flo as described above. Any reasonable assumptions made should be stated as part of your answers accordingly.
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Auditing A Practical Approach
ISBN: 978-1119566007
3rd Canadian edition
Authors: Robyn Moroney, Fiona Campbell, Jane Hamilton, Valerie Warren
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