Posted:6 days ago|
Platform:
On-site
Full Time
Duties and Responsibilities
• Review and process health insurance claims in line with the policy terms, ensuring regulatory compliance.
• Evaluate claim details for completeness and resolve issues by collaborating with insurance providers, policyholders, and internal teams.
• Investigate claim discrepancies and denials, working closely with all parties to facilitate prompt and accurate resolutions.
• Monitor claim status and ensure timely follow-up on unpaid or pending claims.
• Maintain accurate and detailed records of claims processed, communications, and outcomes.
• Collaborate with internal departments to ensure smooth claim processing and resolution.
• Effectively handle escalated claims from policyholders and other external partners that require advanced knowledge or decision-making.
Other duties as assigned from time to time Desired Skills and Experience:
• Bachelor’s degree in Healthcare Administration, Business, or a related field.
• Experience in health insurance claims processing, medical billing, or a related healthcare field.
• Confident in providing prompt and consistent administrative service support.
• Strong analytical, problem-solving, and critical thinking skills. Strong attention to detail and keen sense of accuracy.
• Excellent verbal and written communication skills, with the ability to interact effectively with policyholders, providers, and team members.
• Ability to learn and adapt quickly, and thrive in a high-pressure environment.
• Ability to work on own initiative as well as being a team player.
• Patient, empathetic, adaptable and flexible.
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