
Claims Processor Specialist
1 day ago
We are seeking a highly skilled and detail-oriented Claims Processor to join our team.
This role involves reviewing, processing, and managing claims submitted by customers or clients. The ideal candidate will ensure claims are processed accurately and timely, verify documentation, communicate with customers, and collaborate with other departments to resolve claims issues.
Key Responsibilities:- Claims Review and Processing:
- Receive and review claim forms, ensuring all necessary documents are submitted and complete.
- Process claims according to company guidelines and industry regulations.
- Verify the accuracy of claim information against policy details to ensure eligibility.
- Customer Interaction:
- Communicate with claimants to request additional information or clarify details.
- Respond to customer inquiries regarding claim status and provide updates.
- Resolve customer issues with timely solutions and support.
- Claims Analysis and Reporting:
- Review claims for compliance, identifying potential fraud or discrepancies.
- Assist in preparing claims reports as per client requirements.
- Adherence to Procedures and Deadlines:
- Follow guidelines to ensure timely processing and settlement of claims.
- Maintain internal controls and audit requirements.
- Suggest process improvements for efficiency and accuracy.
- A background in Accounting, BBA, or MBA is required.
- The ideal candidate will have 1-3 years of experience in claims processing or related fields.
- Familiarity with claims management software (SAP) and office tools (Microsoft Office, Excel) is essential.
- Strong attention to detail and accuracy are crucial.
- Excellent verbal and written communication skills are required.
- The ability to multitask and prioritize in a fast-paced environment is vital.
- A basic understanding of claims procedures and regulations is necessary.
- Problem-solving and critical thinking skills are essential.
- Customer service orientation and teamwork ability are required.
- Seniority level: Associate
- Employment type: Full-time
- Job function: Finance and Accounting/Auditing
- Industries: Outsourcing, Claims Adjusting, Actuarial Services, Financial Services
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