Insurance Medical Claims

Position Overview :We are seeking a detail-oriented and experienced Third-Party Bodily Injury Claims Specialist to join our team. The ideal candidate will be responsible for managing and resolving third-party bodily injury claims with a focus on delivering exceptional service while ensuring compliance with company policies and legal requirements.Key...

Job Summary- To handle a limited case load of large and or complex life claims and serve as a referral resource for both Life Claims Technicians and Examiners, to ensure timely and equitable settlement and delivery of excellent customer service.- Job Accountabilities - Key Accountabilities- Ensure that claims processes and procedures meet state and federal...

Process all Life and/or Accident & Hospitalization claims requests received as per stipulated requirements - Process pre-approval requests in accordance with required benchmarks - Evaluate and gather all data for claim processes, prepare medical questionnaire and to review all status and ensure efficient adjustment in claim / underwriting system - Ensure...

To provide advice, sound judgment and recommendation on case that surpasses the authority of a Senior Officer. Provide - advice with appropriate referrals/ escalations as and when needed. - To authorize, deny and determine extent of insurers liability on case of discharge that surpasses the authority of a Senior - Officer. - To ensure claims recommendations...

Key responsibilities - Process and assess Major (Death, CI, TPD, Waiver claim) end to end - Able to identify and flag out potential suspected fraud/non-disclosure while assessing cases - Able to complete the end to end task within the Turn Around Time given acurrately - To liaise with intermediaries in work process - Draft and send correspondence letters...

With 5 - 8 years' experience in medical claims processing, including 2 years of supervisory experienceWith healthcare background is preferredWith in-depth knowledge of medical terminology, billing codes (ICD 9, ICD 10, CPT) and medical insurance policesWith depth knowledge on Fraud, Waste and Abuse (FWA), risk management or compliance frameworksStrong...

At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone. - It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030._ - And to get there, we need...

Job Summary Utilize established financial systems and roll out enhanced analytics capabilities to track budgets and highlight variances in order to achieve financial effectiveness and operational efficiency. Job Accountabilities - Key AccountabilitiesEnsure monthly reporting of Business Units to the data warehouse and constantly improve data quality and...

JOB PURPOSEThe job holder is responsible of serving providers and insurance companies by determining requirements, answering inquiries, resolving problems, fulfilling requests and maintaining database. He/She is responsible for processing as per terms of benefits. He/She should provide accurate and relevant medical coverage details and maintain pre-approvals...

The Motor Claim Specialist is responsible for managing and processing third-party property damage claims related to motor accidents. With over 5 years of experience in the insurance industry, the specialist will handle complex claims, ensuring efficient and fair resolution in line with local regulations and company policies. Objectives & Key Performance...