Claims Investigation Executive
3 weeks ago
We're seeking a skilled Health Claims Processor to join our team. In this role, you'll process health claims while ensuring our department's strategic initiatives support the company's mission and business goals. Key responsibilities include processing and assessing health claims, identifying potential abuses or suspected fraud, and meeting targets for cost avoidance.
Key Responsibilities:
- Process and assess health claims, particularly in investigation cases.
- Identify and flag potential abuses or suspected fraud during claim assessments.
- Assess health claims for potential non-disclosures or pre-existing conditions, and develop strategies to gather evidence.
- Meet targets for cost avoidance.
- Review and resolve outstanding investigation claims.
- Liaise with customers, agents, and doctors to facilitate claim settlements.
- Ensure claims are processed within the department's specified turnaround time.
- Draft and send correspondence independently.
Requirements:
- Graduate in bio-medical science or related studies.
- 2 years of experience in health claims is an advantage.
- Knowledge of medical terms/medical related studies is an advantage.
- Experience in claims investigation.
- Good communication skills in both written and verbal.
- Ability to think out of the box.
We're an equal opportunity employer and welcome applications from diverse candidates. Our company is a leading insurance and asset management company, committed to caring for our employees and customers. We value diversity and inclusivity in our workforce, and we're proud to be an employer of choice for talented individuals like you. Let's care for tomorrow.
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