Claims Account Analyst

3 weeks ago


Philippines Asurion Full time

Overview

Claims Account Analyst is responsible for evaluating claims to ensure they are accurate and processed in a timely manner. They review and assess the validity of claims based on the policy guidelines. They also follow precise procedures in managing high-volume claims according to department goals and deadlines.

Responsibilities
  • Evaluate all claims for accuracy and completeness of documentation.
  • Review, investigate and determine the validity of claims based on the policy guidelines.
  • Process electronic spreadsheets and paper claims submitted by service network-providers in appropriate payment module.
  • Adjudicate claims based on appropriate underwriter and client’s specific business rules.
  • Respond to claim inquiries from both customers and internal stakeholders.
  • Resolve discrepancies or issues with claims.
  • Raise system issues effectively to the proper department.
  • Ensure shared mailbox is being managed well and queries are attended promptly.
  • Issue clear, effective, and accurate communications to internal and external customers.
  • Conduct all interactions with internal and external customers in a positive and professional manner.
  • Report problems and provide alternate solutions to Supervisor.
  • Performs ad hoc activities and tasks as required.
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