
Claims Resolution Expert
23 hours ago
We are seeking a highly skilled Claims Resolution Expert to fill this exciting opportunity.
Key Responsibilities:- Handle end-to-end processing of reimbursement claims for group medical corporate policies, ensuring timely and accurate resolutions.
- Provide exceptional customer service by addressing claims-related queries via various communication channels.
- Analyze medical documentation, policy terms, and conditions to ensure accurate claim assessment and processing.
- Liaise with internal teams, insurers, TPAs, and hospitals to ensure seamless claims settlement.
- Manage claims escalations, ensuring prompt resolution while maintaining a customer-centric approach.
Requirements:
- In-depth knowledge of corporate group medical insurance policies and claims processing procedures.
- Ability to understand medical terminology, treatment procedures, and health-related documentation.
- Proficient in customer support and claims management tools, including data analysis and problem-solving skills.
- Strong communication and interpersonal skills to manage customer relationships and resolve issues effectively.
- Attention to detail to ensure accuracy in claim processing and documentation review.
- Ability to collaborate effectively with cross-functional teams.
Preferred Qualifications:
- Bachelor's degree in healthcare, insurance, or related field.
- 2-4 years of experience in claims processing, CRM role preferably within group medical corporate policies.
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