Associate EB Claims

Client of Business Lobby

Responsibilities

• Serve as the main point of contact for clients, hospitals, TPAs, and insurance companies throughout the claims process.
• Ensure timely, fair, and efficient handling of claims while maintaining strong relationships with all stakeholders.
• Provide accurate updates on claim statuses and address any issues or delays promptly.
• Track pending claims, prepare periodic reports, and ensure accurate data entry.
• Respond to client inquiries regarding plans, coverage details, co-payments, deductibles, premiums, and reimbursement procedures.
• Support the resolution of complex claims in coordination with the direct manager.
• Manage financial follow-ups with insurance companies and clients to ensure timely claim payments and reimbursements.
• Reconcile claims statements, address discrepancies, and provide clear explanations on billing and coverage.
• Handle incoming calls and inquiries, including through the EB hotline when required.
• Coordinate and follow up on documentation such as renewals, quotations, additions, and deletions.
• Assist in preparing departmental reports and presentations, including loss ratio analysis when needed.

Qualifications

• 3 to 5 years of experience in client servicing, insurance, claims management, or a related field.
• Strong understanding of insurance processes, claims workflows, and policy coverage.
• Excellent communication, interpersonal, and customer service skills.
• Strong organizational skills with high attention to detail and accuracy.
• Ability to manage multiple tasks, meet deadlines, and resolve issues efficiently.
• Proficiency in data entry, reporting, and MS Office tools.
• Problem-solving mind-set with the ability to handle complex cases professionally.
• Ability to work under pressure and manage client expectations.
• Flexibility to handle inquiries outside regular working hours when needed.