Claims Processing Agent
Role Overview
Evaluate and process claims efficiently while maintaining customer satisfaction and compliance with company policies.
Key Skills for This Role
Full Job Posting
Role overview
Evaluate and process claims efficiently while maintaining customer satisfaction and compliance with company policies.
Key responsibilities
- Operate within company service standards and clear claims to zero to support customer satisfaction and retention.
- Review and handle claims according to established procedures.
- Support departmental productivity goals and agreed service-level agreements.
- Respond professionally and accurately to client inquiries; coordinate with other departments for prompt resolution.
- Participate in medical training to develop knowledge of medical terminology, procedures, and claims processing.
- Adapt to varied claims-handling tasks and meet quality targets.
- Support the Team Leader in promoting team engagement.
- Handle other ad hoc duties as required.
Requirements
- A bachelor's degree in a medical or paramedical field, finance, business administration, insurance, or a related field is preferred.
- 1–2 years of customer-focused experience; 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 perform under pressure and meet tight deadlines and service standards.
- Work effectively with AI, machine learning, data analytics, and cloud-based tools, applying data governance, security, and ethical-use standards.
Work arrangement
- Hybrid working option is available according to business requirements.
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