Adjudicador de Reclamos - Manizales, Colombia - ttg Talent Solutions

ttg Talent Solutions
ttg Talent Solutions
Empresa verificada
Manizales, Colombia

hace 1 semana

Carolina González

Publicado por:

Carolina González

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Descripción

Claims Adjudicator

Medellín - In-Person

Permanent Position

Salary Expectation:
$3,500,000 to $4,000,000 (Depending on experience)

Description:

The Claims Adjudicator is responsible for evaluating and processing claims in accordance with policy benefits and contractual conditions. Maintaining high-quality standards by ensuring accurate claims adjudication.


RESPONSIBILITIES AND FUNCTIONS:


Essential Functions:


  • Review and adjudicate claims based on policy benefits.
  • Submit claims for coverage analysis to the medical department in specific cases.
  • Generate reports.
  • CTP coding.
  • ICD10 coding.
  • Validate banking information.
  • Associate medications with the presented diagnosis.
  • Validate expenses with coverage renewal dates.
  • Calculate expenses and deductibles per policy year.
  • Validate waiting periods.
  • Validate preexisting conditions, exclusions, and deductible increases.
  • Validate service dates.
  • Perform currency conversions.

Requirements (Knowledge and Skills):


  • Student or holder of a degree in Business Administration or related fields.
  • Minimum of two years of experience in the field.
  • Experience in highquality customer service.
  • Competence in relevant software utilities.
  • Effective communication, both oral and written.
  • Ability to work under pressure.
  • Dynamic and energetic.
  • Strong interpersonal skills.
  • Ability to follow oral and written instructions.
At ttg,
_"We believe in making a difference One Person at a Time,"_ ttg OPT
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