Claims Administrator
1 week ago
About the Role:
The role of an insurance claim processor is to manage and process claims efficiently and accurately, ensuring timely closure for policyholders.
The primary goal of this position is to facilitate smooth and timely claim processing, allowing employees to receive the benefits they are entitled to.
Key Responsibilities:- Process Claims: Review and verify policy details to ensure that the claim is eligible for processing according to the terms and conditions of the insurance policy.
- Act as a Claims Liaison: Manage end-to-end claim processes for employees, including coordinating with insurers, verifying medical records, and ensuring accurate and efficient processing.
- Provide Customer Service: Respond to inquiries from employees and other stakeholders regarding claim status and related queries.
- Coordinate with Healthcare Providers/Hospitals: Communicate with healthcare providers to obtain additional information, clarify details, and resolve any discrepancies or issues that may arise during the processing of claims.
- Maintain Records: Keep detailed and accurate records of all claim-related activities, communications, and transactions for documentation and audit purposes.
- Meet Performance Metrics: Meet or exceed established service level agreements and performance metrics related to claim processing, turnaround time, accuracy, and customer satisfaction.
Required Skills and Qualifications:
- At least 2 years of experience in customer-facing roles.
- Past Experience in handling similar roles would be beneficial.
- Experience in claim processing/cashless/TPA.
Benefits:
This role offers an opportunity to work in a dynamic environment, handle various responsibilities, and develop skills in claim management. You will have the chance to work closely with different stakeholders, including customers, healthcare providers, and insurers.
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