Claims Officer

Key Responsibilities

• Serve as the primary point of contact for clients, hospitals, TPAs, and insurance companies throughout the claims process.
• Actively advocate for clients' best interests, ensuring prompt and equitable resolution of claims.
• Build strong relationships with clients, providers, and insurers to facilitate efficient communication and problem-solving.
• Provide timely and accurate updates to clients on the status of their claims.
• Identify and address potential issues or delays in the claims process.
• Keep track of pending claims and follow-up on their resolution.
• Prepare periodic reports on claims and production along with feedback.
• Work on data entry, ensuring accuracy and correcting any discrepancies.
• Provide clients with prompt and accurate responses to inquiries regarding plans, coverage details, copayments, deductibles, premiums, and claims procedures and or reimbursement.
• Develop and implement effective strategies to resolve complex claims in close coordination with the direct manager.
• Maintain a high level of customer satisfaction through exceptional service and communication.
• Stay up-to-date on industry products, solutions, regulations, policies, and procedures.
• Efficiently handle incoming calls and inquiries from clients regarding insurance coverage and claims and general inquiries through the EB hotline, even on weekends and days off.
• Proactively follow up with insurance companies and clients to ensure timely payment of insurance claims and receipt of reimbursements.
• Manage financial aspects of client accounts, including processing claims payments, reconciling claims statements, and coordinating reimbursements.
• Provide clients with clear and concise explanations regarding insurance coverage, billing, and payment options.
• Identify and address any financial concerns or discrepancies promptly to the direct manager.
• Meticulously track and follow up on documents and paperwork to ensure timely completion and submission.
• Assist the EB Department in all reports and presentations such as but not limited to loss ratio preparation and analysis when needed.
• Coordinate and monitor the production process, including renewals, quotations, additions, and deletions.

We are seeking a Claims Officer for an Insurance Company in Beirut, ;The Claims Officer is responsible for managing the entire claims process, acting as the primary contact for clients, hospitals, and insurers. This role ensures timely resolution of claims, provides clients with accurate updates, and maintains strong relationships with all parties involved. Additionally, the Claims Officer follows up on payments, addresses financial discrepancies, and ensures proper documentation for all claims and related processes.