Health Insurance Specialist

Role Overview: You will be responsible for handling health insurance claims and providing customer support related to coverage, benefits, and claims. Additionally, you will review policies for accuracy, ensure compliance with health insurance regulations, coordinate with healthcare providers, detect fraud in claims, and maintain detailed records of claim activities. Key Responsibilities: - Analyze and process insurance claims according to policy terms and conditions. - Assist policyholders with inquiries regarding coverage, benefits, and claims. - Ensure accuracy in medical records, billing statements, and insurance documentation. - Stay informed about health insurance laws and regulations to maintain compliance. - Collaborate with healthcare providers to clarify diagnoses and gather additional information for claims. - Identify and report any suspicious or fraudulent claims. - Maintain precise records and generate reports on claim activities. Qualification Required: - Bachelor's degree in a related field. - 5-10 years of experience in health insurance claims management. - Strong knowledge of health insurance policies, laws, and regulations. - Excellent communication and problem-solving skills. - Ability to work collaboratively with policyholders and healthcare providers. Please note: Interested candidates are requested to share their updated resumes by contacting the provided phone number: 63698 43028. If you have any further questions or need clarification, please feel free to contact us. (Note: The additional details of the company were not included in the provided job description) Role Overview: You will be responsible for handling health insurance claims and providing customer support related to coverage, benefits, and claims. Additionally, you will review policies for accuracy, ensure compliance with health insurance regulations, coordinate with healthcare providers, detect fraud in claims, and maintain detailed records of claim activities. Key Responsibilities: - Analyze and process insurance claims according to policy terms and conditions. - Assist policyholders with inquiries regarding coverage, benefits, and claims. - Ensure accuracy in medical records, billing statements, and insurance documentation. - Stay informed about health insurance laws and regulations to maintain compliance. - Collaborate with healthcare providers to clarify diagnoses and gather additional information for claims. - Identify and report any suspicious or fraudulent claims. - Maintain precise records and generate reports on claim activities. Qualification Required: - Bachelor's degree in a related field. - 5-10 years of experience in health insurance claims management. - Strong knowledge of health insurance policies, laws, and regulations. - Excellent communication and problem-solving skills. - Ability to work collaboratively with policyholders and healthcare providers. Please note: Interested candidates are requested to share their updated resumes by contacting the provided phone number: 63698 43028. If you have any further questions or need clarification, please feel free to contact us. (Note: The additional details of the company were not included in the provided job description)