Claims Processing Agent

Job Description

We are looking for a detail-oriented and motivated Claims Processing Agent to join our team. In this role, you’ll be responsible for evaluating and processing claims efficiently while insuring high standards of customer satisfaction and compliance with company policies.

Key Responsibilities

  • Operate within and meet the conditions of company service standards, clear to zero, to guarantee customer satisfaction and retention.
  • Review and handle claims according to the established standard procedure.
  • Support the team and departmental productivity goals to meet the agreed upon Service Level Agreement (SLA) and deliver exceptional customer service
  • Provide accurate and professional responses to client inquiries, and if needed, collaborate with other departments to ensure prompt and efficient resolution.
  • Engage in departmental medical training to broaden understanding of medical terminology and procedures, and enhance proficiency in claims processing skills.
  • Ensures adaptability in various claims handling work-related tasks to be able to facilitate a multi-tasking role.
  • Ensures that high quality targets (standard of work performance) are achieved at all times.
  • Support the Team Leader to drive engagement within the Team
  • Other Ad hoc duties as required

Job Requirements

  • Bachelor’s degree in any Medical field, Paramedical, Finance, Business Administration, Insurance, or a related field preferred.
  • 1-2 years’ experience in a customer focused environment, ideally in clinical, paramedical roles or TPA or insurance roles.
  • Proficiency in MS Office
  • A highly customer-focused individual with strong interpersonal, communicative and accuracy skills.
  • Team player
  • Physically fit to carry out duties.
  • Ability to demonstrate sounds work ethics.
  • Ability to work under pressure and to meet tight deadlines and service standards
  • Legally permitted to work in the country of operations.
  • Hybrid working option available as per business requirements.