Claims Processing Agent
Role Overview
Detail-oriented and motivated Claims Processing Agent role focused on efficient claim evaluation and processing, customer satisfaction, and compliance with company policies.
Key Skills for This Role
Full Job Posting
Role overview
Detail-oriented and motivated Claims Processing Agent role focused on efficient claim evaluation and processing, customer satisfaction, and compliance with company policies.
Responsibilities
- Meet service standards and support customer satisfaction and retention.
- Review and handle claims using established procedures.
- Support team productivity goals and service-level agreements.
- Respond accurately and professionally to client inquiries; coordinate with other departments for prompt resolution when needed.
- Participate in medical training to build knowledge of medical terminology and procedures and improve claims-processing skills.
- Adapt to varied claims-handling tasks, maintain quality targets, and support the Team Leader in team engagement.
- Handle other ad hoc duties as required.
Requirements
- A bachelor's degree in a medical, paramedical, finance, business administration, insurance, or related field is preferred.
- 1–2 years of customer-focused experience is sought; clinical, paramedical, TPA, or insurance experience is ideal.
- Proficiency in MS Office.
- Strong customer focus, interpersonal and communication skills, and accuracy.
- Teamwork, adaptability, sound work ethics, and ability to work under pressure and meet deadlines and service standards.
- Ability to work responsibly with AI, machine learning, data analytics, and cloud-based tools while observing data governance, security, and ethical-use standards.
Workplace
- Hybrid working option is available as per business requirements.
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