Claims Processing Agent
Role Overview
The Claims Processing Agent evaluates and processes claims while supporting customer satisfaction and compliance with company policies.
Key Skills for This Role
Full Job Posting
Role overview
The Claims Processing Agent evaluates and processes claims while supporting customer satisfaction and compliance with company policies.
Responsibilities
- Meet company service standards, including clear-to-zero targets, to support customer satisfaction and retention.
- Review and handle claims according to established procedures.
- Support team productivity goals and agreed service-level targets.
- Respond professionally and accurately to client inquiries, coordinating with other departments when needed.
- Participate in medical training to build knowledge of terminology, procedures, and claims processing.
- Adapt to varied claims tasks, maintain quality targets, support team engagement, and handle ad hoc duties.
Requirements
- A degree in a medical, paramedical, finance, insurance, or related field is preferred.
- 1–2 years of customer-focused experience; clinical, paramedical, TPA, or insurance experience is ideal.
- Proficiency in MS Office.
- Customer focus, interpersonal and communication skills, accuracy, teamwork, and sound work ethics.
- Ability to work under pressure and meet deadlines and service standards; physical fitness to carry out duties.
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