Job Description
Responsibilities:
- Supervise and provide daily operational support to Claim Analysts Head to ensure efficient workflow and service delivery.
- Review, evaluate, and approve complex or high-value claims in accordance with policy and medical guidelines.
- Monitor team performance against SLA, accuracy, and productivity.
- Handle escalated cases, disputes, and critical claims with strong judgment and stakeholder coordination.
- Conduct quality control reviews and continuously improve claim processes.
- Actively participate in claim system development and enhancement initiatives, ensuring alignment with business needs.
- Provide business and medical insights to strengthen claim rules, fraud detection, and automation processes.
Requirements:
- Bachelor’s Degree in Medicine.
- Min. 5-6 years of experience as claim analyst in the insurance industry.
- Proven experie...