Health Support Associate

Job Summary

Experience

• Minimum 2 years of experience in health insurance, healthcare administration, medical claims processing, or customer service.

Education

• Bachelor's Degree or Diploma in Healthcare Administration, Business Administration, Insurance, or a related field.

Technical Skills

• Knowledge of health insurance terminology, benefits, and policy coverage.
• Experience in claims processing, pre-authorizations, and healthcare coordination.
• Proficiency in Microsoft Office applications.
• Strong documentation and record management skills.

Mandatory Criteria

• Excellent customer service and communication skills.
• Strong attention to detail and accuracy.
• Ability to work under pressure and manage multiple tasks.
• Knowledge of medical coding or claims processing will be an added advantage.
• Familiarity with health insurance regulations and compliance requirements.

Key Responsibilities

• Serve as the primary point of contact for policyholders, healthcare providers, and corporate clients regarding health insurance inquiries.
• Verify member eligibility, policy benefits, and coverage details.
• Assist in processing medical claims and ensure all required documentation is complete and accurate.
• Coordinate with hospitals and clinics for approvals, referrals, and pre-authorizations.
• Handle customer inquiries via phone, email, and online portals while maintaining high service standards.
• Maintain and update member records, policy information, and service documentation.
• Escalate complex medical or operational issues to the appropriate departments.
• Monitor service turnaround times and ensure compliance with Service Level Agreements (SLAs).
• Support customer service initiatives and case management activities.
• Ensure compliance with company policies and applicable insurance regulations.

Documents Required

• Updated CV
• QID Copy