Claims Officer
bolttech · Philippines
In this position you will....
will be involved in medical claims by determining insurance coverage; examining and resolving medical claims; complete documentation; maintaining quality customer services and ensuring legal compliance.
You will be responsible for…
- Manage, develop and lead the team to achieve the targeted KPI.
- Monitor and manage claim activities to ensure delivered service as commitment.
- Build-up SLA and KPI, measure performance for the team, conduct performance reviews and provide input into discussions around individual performance.
- Scrutinize claims processed by Claims executives for accuracy and efficiency.
- Ensure SOPs are followed by all executives and process compliance is optimal.
- Analyze and deep dive in complaints to not only give out solutions but also keep brand name of the client and the company
- Conduct coach session/ training to improve and enhance CA’s knowledge.
- Provide Activity Report as Team performance report daily, weekly and monthly bases.
For you to be successful…
We expect you to be able to demonstrate the following key competencies
Curious
- Motivated and self-directed, identifying opportunities to grow and acquire new knowledge from a range of sources. Has a sound comprehension of relevant multi-discipline areas of expertise.
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Demonstrates reflection and solicits feedback from others. Evaluates and learns from set-backs and adversity.
Communication
- Effective and articulate communicator actively and respectfully listens to and synthesizes others’ perspectives.
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Concise in communicating and references relevant information tailored to the audience to support points.
Collaborative
- Inclusive, empathetic and encourages and facilitates other team members to unite and deliver positive results.
- Develops strategic relationships and networks across the organization and shares with others for mutual benefit.
Adaptable
- Is quick to adapt approach and act flexibly in response to changes in the strategic and/or operational direction of the organization.
- Modifies style and leverages different approaches depending on different situations and circumstances.
You will require the following qualifications and skills
- Graduation in any stream or ITI or Diploma in Mobile Repair or related field.
- 5 - 8 years of relevant experience in Insurance industry or any brand repair center
- Experience in claim processing.
- Backend operation experience (Insurance, Banking & Finance)
- Team handling experience.
- Possess good leadership, achieve cooperation and collaboration among all functions.
- Good communication and interpersonal skills
- Good verbal and written communication skills in English.
- Customer-centric mindset are advantageous.
- Highly motivated and able to work independently.
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