Job Functions:

• Handle more complex or high-priority claims, ensuring all documentation is complete, accurate, and in

compliance with relevant policies and regulations.

• Process claims within established timelines, ensuring the appropriate action is taken for claim approval,

rejection, or escalation.

• Assist in determining settlements or payouts in accordance with company guidelines, policies, and

procedures.

• Handle escalated claims or issues that cannot be resolved by junior staff, ensuring timely and effective

solutions.

• Identify and resolve minor issues or discrepancies in claims processing.

• Flag more complex cases to senior staff or managers for further investigation and resolution.

• Review and ensure the accuracy of claims data entered by junior staff, making recommendations for

corrections and improvements as needed.

• Follow up with ...