Health and Benefits Claims Specialist
Location
Jordan | India
Job description
Job Description
As
H&B Claims Specialist , you will work to manage and monitor client's claims submissions and claims pre-approvals. You will be in day to day communication liaison with Consultants, Clients, Client Members, Insurers, and Third Party Administrators.
Performance Objectives Clients - Conduct regular clients visits to collect and review claims and discuss any issues related to claims.
- Gathers and reviews loss information and prepares claim status reports.
- Responds to and advocates on claims, coverage and eligibility questions from clients
- Collects, reviews and records rejections and settlements
- Acts as a liaison between carriers and clients, addressing service issues and monitoring for trends.
- Develops and fosters positive relationships with clients and carriers
- Acts as a referral point and mentor for the team
Excellence - Coordinates the servicing of all accounts in accordance with client requirements and H&B Excellence Model
- Advocates high quality of client deliverables, ensuring it is peer reviewed and follows company standards
Financial - Identify areas of for improvement in claims processes leading to efficiencies
People - Complete mandated trainings
- Work collaboratively within the office and foster an atmosphere of respect and spirited teamwork
Qualifications The Requirements - 3-5 years experience of insurance claims handling or advocacy.
- Bachelor's degree in pharmacy or Medicine is a must
- Computer literacy
- Working knowledge of Excel, MS Project, MS Word
- Claims system experience preferred
- Knowledge of the Market Service Organizations (MSOs) such as adjusters, accountants and other experts likely to be appointed by carriers.
- Knowledge of specific claims area.
The Application Process - Stage 1: Online application and recruiter review
- Stage 2 Live video interviews with hiring managers
- Stage 3: Offer and onboarding
WTW is an equal opportunity employer
Job tags
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