About the Role
About The Role
The Claims Representative is responsible for accurate and timely processing of international medical claims from global providers, in line with contractual obligations, and standard operating procedures requirements. The role operates in a structured, high-volume environment and requires consistent judgement, disciplined process execution, and clear communication with internal stakeholders.
Responsibilities
Process provider claims against policy and benefit rules, delivering decisions that meet quality and turnaround time standards.
Validate and reconcile claim data across Administration, Workflow, and CRM platforms; ensure completeness, coding alignment, and internal consistency.
Maintain full compliance with confidentiality, data protection, medical privacy, and audit documentation requirements.
Identify and escalate claims issues in a concise context meeting both customer and provider satisfaction standards.
Communicate relevant escalation updates...
The Claims Representative is responsible for accurate and timely processing of international medical claims from global providers, in line with contractual obligations, and standard operating procedures requirements. The role operates in a structured, high-volume environment and requires consistent judgement, disciplined process execution, and clear communication with internal stakeholders.
Responsibilities
Process provider claims against policy and benefit rules, delivering decisions that meet quality and turnaround time standards.
Validate and reconcile claim data across Administration, Workflow, and CRM platforms; ensure completeness, coding alignment, and internal consistency.
Maintain full compliance with confidentiality, data protection, medical privacy, and audit documentation requirements.
Identify and escalate claims issues in a concise context meeting both customer and provider satisfaction standards.
Communicate relevant escalation updates...
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