communicate properly with clients, insurance companies and other team members and managers:
- Processing claims and pre-authorization requests in a timely manner
- Communicating and coordinating with key clients / VIP group, insurance companies, and colleagues
- Answering customer’s claims related questions and complaints
- Organizing follow ups related to claims with insurance companies and customers in an efficient and pro-active manner
- Providing excellent customer service to key clients and support with their claims
- Using critical thinking and policy knowledge to analyze whether the insurer has processed a claim correctly and challenging insurer in case of incorrect assessment
- Updating and monitoring of internal database and claims page on a daily basis
- Maintaining organized e-mails, Outlook folders, and clean inbox at all times
- Maintaining organized claims folders in the server
- Organizing problem claim list on a daily basis
- Assisting clients with claims submission when appropriate
- Arranging delivery of cheque reimbursements / claims summary/related documents to clients when necessary
- Pro-actively calling insurance companies and clinics/hospitals to arrange direct billing when necessary
- Ensuring that complicated claim cases are escalated to the manager / sales representative if it becomes too difficult to handle
- Any projects or tasks are assigned by the Claims Manager
