
Claims Processing Specialist
17 hours ago
Health Insurance Claims Advisor Role
Job Summary:The Health Insurance Claims Advisor plays a vital role in ensuring seamless claims processing. This position involves verifying policyholder eligibility, communicating effectively with customers, and gathering information to understand and articulate claim status.
Key Responsibilities:- Verify policyholder eligibility and coverage details before claim adjudication.
- Communicate effectively across multiple channels, including phone, email, chat, and text.
- Gather information from multiple source systems to understand and articulate claim status.
- Ensure accurate data entry and documentation of claim details in the system.
- C coordinate with healthcare providers to validate treatment and billing information.
- Identify and escalate potential fraud or abuse cases to the compliance team.
- Bachelor's degree in Insurance, Healthcare Administration, or related field.
- 1-3 years of experience in health insurance claims processing.
- Basic understanding of health insurance regulatory framework.
- Proficiency in claims processing systems and MS Office tools.
- Fluency in Mandarin, Cantonese, and English (speak, read, and write).
This is an exciting opportunity for individuals passionate about delivering exceptional customer service and ensuring smooth operation of health insurance claims processing. If you are a detail-oriented and organized professional with strong background in insurance or healthcare administration, we encourage you to apply.
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