Insurance Claims Adjuster - Health Insurance

What role you will play in team: You will handle the investigation and settlement of health insurance claims. Your work will help ensure fair and timely payments to our policyholders.

What you will do: You will investigate claims, verify medical information, assess the validity of claims, and communicate with healthcare providers and policyholders.

Key responsibility:

• Investigate health insurance claims, reviewing medical records and documentation.
• Verify the validity of claims by contacting healthcare providers and policyholders.
• Assess the amount of coverage based on the policy and medical information.
• Process claim payments and manage claim files.
• Communicate with policyholders, providers, and other stakeholders to resolve any issues.
• Maintain accurate and detailed records of all claims.
• Adhere to company policies and regulatory guidelines.
• Identify and report any fraudulent activities.

Required Qualification and Skills:

• Bachelor's degree in a related field or equivalent experience.
• Knowledge of health insurance policies and procedures.
• Strong investigative and analytical skills.
• Excellent communication and interpersonal skills.
• Proficiency in Microsoft Office Suite.

Benefits Included:

• Competitive salary and benefits package.
• Opportunities for professional growth and development.
• Supportive and collaborative work environment.
• Comprehensive training program.

A Day in the Life: A typical day involves investigating health insurance claims, contacting doctors and patients, and processing payments while maintaining compliance with regulations.