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Assistant Manager, Medical Claims at Great Eastern Life Assurance Co Ltd

Cuenca, Azuay, Ecuador -

Full Time

Start Date

Immediate

Expiry Date

05 Feb, 26

Salary

0.0

Posted On

07 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Assessment, Customer Service, Analytical Skills, Communication Skills, Medical Knowledge, Documentation, Process Improvement, Team Player, Integrity, Accountability, Attention to Detail, Initiative, Adaptability, Relationship Management, Regulatory Compliance, Problem Solving

Industry

Insurance

Description

You will be handling insurance claims assessment under the accident and health plans. You will also be given the opportunity to be part of an exciting team with involvement in service excellence initiatives and projects to improve the claims experience. · Determine policy coverage, establish proof of loss with proper documentation and provide accurate and timely assessment of medical claims within the required service standards and ensure that claims are paid accurately and promptly · Handle manual submission claims. · Seek clarifications and liaise with medical institutions and policyholders on outstanding requirements · Deliver excellent service and enhance customer and distribution channels relationship management · Attend to escalated claims enquiries · Suggest and participate in process improvement projects/ initiatives/ system enhancement, including establish claims best practices · Ensure compliance with internal and external regulatory and legal matter. · Any other ad-hoc projects assigned by supervisor · Diploma or Degree or Professional Insurance Certificate with at least 3 years of relevant accident and health claims experience. · Prior experience in life and PA claims will be an added advantage · Strong analytical, written and communication skills · Good medical knowledge and ability to explain medical conditions in insurance context · Customer-centric and meticulous with the ability to work under pressure · A team player · High level of integrity, takes accountability of work and good attitude over teamwork. · Takes initiative to improve current state of things and adaptable to embrace new changes.

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Responsibilities

The Assistant Manager, Medical Claims will assess insurance claims under accident and health plans, ensuring accurate and timely processing. Responsibilities include handling manual submissions, liaising with medical institutions, and participating in process improvement initiatives.