Job description
Client Background: The Company is one of the largest health service organizations in the United States. Their mission is to help the people we serve improve their health, wellbeing and sense of security. Their operating subsidiaries provide an integrated suite of medical, dental, behavioral health, pharmacy and vision care benefits, as well as group and individual life, accident and disability insurance, to millions of people throughout the United States and around the world.
Industry: Insurance backend
Location: KL Sentral
Headcount: Multiple
Tenure: Permanent
Remuneration: Basic salary
Responsibilities:
- Adjudicate medical/dental and vision claims in accordance with policy terms and conditions
- Identify claims where further information is required working towards SLA and timescales
- Monitor and highlight high cost claims and ensure relevant parties are aware
- Monitor turn around times to ensure your claims are settled within required time scales to meet client SLA’s
- Identify potential process improvements and make recommendations
- Actively support other team members and provide resource to enable all team goals to be achieved
- Manage customer instructions through the development of high quality interpersonal skills
- Achieve personal and team productivity and quality goals
- Ensure work is prioritized effectively
- Work closely with other departments in line with service needs
- Carry out other adhoc tasks as required meeting business needs
- Flex between all of the above activities based on current customer demand
- Flex your working shift based on current customer demand
- Achieve personal and team productivity and quality goals
- Carry out other ad-hoc tasks as required meeting business needs
- Performs research to respond to inquiries and interprets policy provisions to determine most effective response.
Requirements:
- Diploma/ Degree holder in any field.
- 1-2 years of related experience.
- Open for fresh graduates too.
- Good communication skills.
- Good mathematical skills.
- Familiar with insurance claims related tasks.
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