Healthcare & Insurance Operations Senior Representative
7 days ago
HC & Insurance Operations Senior Rep.
Position's General Duties and Tasks:
In this role you will be responsible for:
Life Claims:
- Processing Death Claims and identifying the right beneficiary(s) to provide the Claims benefit
- Setting up a claim and then following up for pending requirements (if any)
- Examining the received documents, payment calculation and settlement
- Perform additional review before cutting the check
Health Claims:
- Supporting different set of Health Claims products which includes Wellness, Critical Illness, Accident, Cancer, HI etc.
- Check the eligibility of the members product wise who will undergo different set of medical examination proceeding with additional care/treatment
- To perform adjudication which will cover the additional review of the medical history proceeding with medical benefits
Requirements for this role include:
- 0 -1 Year of experience in any Healthcare BPO
- University degree or equivalent that required 3 years of formal studies
- 1 year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools.
- Ability to work scheduled shifts from Monday-Friday 06:00 PM to 04:00 AM and to be flexible to accommodate business requirements
- Ability to communicate (oral/written) effectively in English to exchange information with our client.
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