Process Executive
- Cognizant
- 0 - 1 years
- Coimbatore
- 5 months ago
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Job Description
- - Assist in validating and processing health insurance claims in accordance with Hong Kong Insurance Authority (IA) guidelines.
- - Ensure accurate data entry and documentation of claim details in the claims management system.
- - Support the review of claims for completeness and compliance with policy terms and conditions.
- - Coordinate with internal departments to gather missing documentation or information.
- - Flag potential discrepancies or anomalies for further review.
- - Maintain confidentiality and data protection standards in handling sensitive health information.
- - Respond to basic inquiries from policyholders regarding claim status and documentation requirements.
- - Ensure timely processing of claims to meet service level agreements (SLAs).
- - Assist in generating reports for internal tracking and audit purposes.
- - Stay updated on changes in claims procedures and regulatory requirements in Hong Kong.
- - Support continuous improvement initiatives in claims processing workflows.
- - Participate in training sessions related to claims systems and regulatory updates.
- Service and resolve inquiries from customers, members, beneficiaries, and others regarding Health Care products and benefits across multiple product lines
- Ability to communicate effectively across multiple channels, including phone, e-mail, chat, and text
- Ability to succinctly collect information from a customer to set up a new claim
- Ability to gather information from multiple source systems to understand and articulate the status of a claim and what information may be needed, next steps in processing, etc.Role & responsibilities
Preferred candidate profile
- - Bachelors degree in Insurance, Business Administration, Healthcare Management, or related field.
- Proficiency in Microsoft Office and claims management software.
- Strong attention to detail and organizational skills.
Job Classification
Industry: IT Services & ConsultingFunctional Area / Department: Customer Success, Service & OperationsRole Category: Customer Success, Service & Operations - OtherRole: Customer Success, Service & Operations - OtherEmployement Type: Full timeContact Details:
Company: CognizantLocation(s): Coimbatore+ View Contact
Keyskills: Claims Adjudication Claims
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