Claims Analyst null

Job Description:

The Claims Adjudicator handles Claims financial processing mainly settlement request. This role is also responsible for identifying paperwork for beneficiary whether In Good Order (IGO) or Not In Good Order (NIGO) and should be followed-up via call out. This role also includes Claims indexing which segregates items from settlements and notifications.

Key Accountabilities:

• Responsible for creating death benefit package and sending out correspondence to obtain missing documents via fax/mail or email.
• Report overpayments, underpayments, and other irregularities.
• Processing of high priority Claims Financial transactions involving settlements, identification and closing of policies, freezing of assets and notification to Beneficiaries of settlement requirements.
• Identification of transactions that needs to be forwarded back to the Business Unit and/or to other departments/teams
• Investigate, evaluate and settle claims, applying technical knowledge and analytical skills which in effect does have fair and prompt disposal of cases and to contribute to a reduced loss ratio.
• Perform call task (inbound and/or outbound) in order to facilitate completion of death claims processing
• Confer with legal counsel on claims requiring litigation.                                         

Minimum Experience:

• College/University graduate preferably with previous related work experience in the financial services or call center industry and demonstrated service aptitude

Technical Skills:

• Computer literate - ability to use the desktop computer system. Advance knowledge on MS application like Word and Excel.
• Booting and shutting down computer, using mouse and keyboard (keyboarding)
• Knowledge of browsers and relevant computer applications
• Ability to use the phone system/Follows simple instructions on how to log in to the phone system
• Basic telephony skills

Soft Skills:

• Excellent written and verbal communication skills.
• Strong customer service skills (ability to build rapport, demonstrate empathy and outline key steps in delivering good customer service).
• Ability to clearly understand and act on presented problem statement; to comprehend, capture as well as interpret basic customer information.
• Minimum keyboarding skills of at least 30 words per minute. Exhibits good navigation skills.
• Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
• Ability to recommend means of obtaining and analyzing transactional data, as well as evaluate the accuracy of business transactions in accordance with company procedures and contracts.
• Ability to work independently and remain self-motivated with minimal direct supervision.
• Ability to identify business process improvements and report existing deficiencies to management.