YOUR ROLE
- Verification of cover in order to determine if indeed there is coverage/policy in-force when the loss occurs
- Makes the necessary recommendation on a claim (such as for final action or to require further documents or information) or makes a final decision on claim, in accordance with the claim's authority
- Handles the necessary communication that should be provided to claimants
- Ensures proper documentation of cases evaluated
- Handles inquiries of the status of a claim
- Provides claimants with appropriate and prompt explanation of claims benefits which may not be payable or limited
- Assesses additional or new information on a denied claim or a claim with limited benefits payout and determine if there are grounds for consideration or a revised recommendation
- Maintains the confidentiality of claims records
- Should at all times meet the department's standards for quality and turnaround time
- Deals with third-party administrations (TPAs), adjusters and other service providers
- Performs other duties as necessary in meeting the objectives/mission of the department or as assigned by superior
A BIT ABOUT YOU
- Graduate of a bachelor's degree course (preferably with medical background)
- At least 3 years' work experience in similar capacity
- Proficient in Microsoft office
- Amenable to work onsite daily
Job Type: Full-time
Schedule:
- 8 hour shift
- Day shift
Work Location: In person
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