Claims Specialist

2 weeks ago

Bonifacio Global Metro Manila, Philippines HGS Offshore Staffing Solutions Full time

Urgent Hiring| Onsite| Night Shift

Required count - 30

Start Date : ASAP

Claims Processors are involved in managing a claim from beginning through to settlement. They ensure that claims are handled efficiently and that payment for valid claims is made to their policyholders.

POSITION DESCRIPTION

  • Interact with customers and act as a liaison between clients and companies by providing information to address inquiries regarding products and services
  • Assist and help resolve any client inquiries, errors, account questions, billing, cancelations, and other queries about products and services
  • Answer questions, offer advice, resolve routine problems in service, and serve as advocates for client's customer service brand
  • Process new Claims policies, modify existing ones and obtain information from policyholders to verify the accuracy of their accounts
  • Calculate the amounts of claims, apply rating systems to claims, contact people involved in claims to obtain relevant information and recommend claim actions
  • Assist claimants, providers and clients with problems or questions regarding their claims and/or policies whilst complying with state laws, policy and company procedures
  • Make follow up outbound calls to customers and other parties as a part of case resolution process
  • Ensure all client enquiries are recorded into the system, confirming all contact details of the enquirer with 100% accuracy
  • Reviews claims thoroughly and to makes sure that all information are complete and correct; updates records of claims and follow up on lapsed cases

POSITION REQUIREMENTS

  • 2+ years of experience in an international BPO
  • Previous experience in the healthcare industry is an advantage
  • Excellent English Communication skill (Verbal and Written)

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