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Role Overview:
We are hiring for one of our clients, seeking an Insurance Claim Specialist to work on a contractual basis. This role involves processing and managing insurance claims with accuracy and efficiency, ensuring compliance with company policies and regulatory standards. The work directly impacts customer satisfaction and operational integrity in the insurance sector.
Key Responsibilities:
• Review and validate insurance claim applications for completeness and accuracy, ensuring all required documentation is provided.
• Assess claims against policy terms and conditions to determine eligibility and appropriate payout amounts.
• Communicate with claimants, healthcare providers, and third parties to gather additional information or clarify discrepancies.
• Maintain detailed records of claim processing activities, including updates and decisions, in the designated system.
• Escalate complex or unresolved claims to senior staff for review, following established protocols.
Required Skills & Qualifications:
• Minimum of 2 years of experience in insurance claim processing or a related administrative role, with a focus on accuracy and attention to detail.
• Proficiency in using claim management software and Microsoft Office Suite, particularly Excel for data entry and analysis.
• Strong understanding of insurance policies, terminology, and compliance requirements in the claims process.
• Ability to interpret medical or legal documents when relevant to claim evaluation, ensuring proper documentation is submitted.
• Excellent written and verbal communication skills, with the ability to interact professionally with claimants and stakeholders.
More About the Opportunity:
This role offers the opportunity to contribute to a structured claims processing system, supporting a high-volume workflow with clear performance metrics. The position is ideal for individuals with prior insurance experience seeking a flexible, remote contract engagement. Contract duration is project-based, with potential for renewal based on performance and workload.
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