Job Description

Remote WorkFull-Time

Duties and Responsibilities

Review and process health insurance claims in line with the policy terms, ensuring regulatory compliance. Evaluate claim details for completeness and resolve issues by collaborating with insurance providers, policyholders, and internal teams. Investigate claim discrepancies and denials, working closely with all parties to facilitate prompt and accurate resolutions. Monitor claim status and ensure timely follow-up on unpaid or pending claims. Maintain accurate and detailed records of claims processed, communications, and outcomes. Collaborate with internal departments to ensure smooth claim processing and resolution. Effectively handle escalated claims from policyholders and other external partners that require advanced knowledge or decision-making. Other duties as assigned from time to time

Desired Skills and Experience:

Bachelor's degree in Healthcare Administration, Business, or a related field. Experience in health insurance claims processing, medical billing, or a related healthcare field. Confident in providing prompt and consistent administrative service support. Strong analytical, problem-solving, and critical thinking skills. Strong attention to detail and keen sense of accuracy. Excellent verbal and written communication skills, with the ability to interact effectively with policyholders, providers, and team members. Ability to learn and adapt quickly, and thrive in a high-pressure environment. Ability to work on own initiative as well as being a team player. * Patient, empathetic, adaptable, and flexible.