
Claims Specialist
3 days ago
Job Description:
We are seeking a detail-oriented and customer-focused professional to process and evaluate health insurance claims with accuracy and fairness. As a key member of our team, you will be responsible for verifying policy coverage, eligibility, and supporting documents in accordance with industry regulations.
Main Responsibilities:
- Process and evaluate health insurance claims with precision and empathy.
- Verify policy coverage, eligibility, and supporting documents in accordance with company policies and insurance regulations.
- Maintain accurate records and follow up on pending claims to ensure timely resolution.
- Communicate effectively with customers and provide regular updates on claim status.
Requirements:
- Experience in health insurance claims handling or management, preferably in a TPA or insurer background.
- Strong understanding of insurance processes and regulations.
- Excellent customer service and communication skills (written and verbal).
- Strong analytical, problem-solving, and attention-to-detail abilities.
- Ability to work independently and as part of a collaborative team.
- Bachelor's degree in Commerce, Healthcare, Insurance, or a related field is preferred.
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