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Medical Claims Officer

Besst Group > Jobs > Claims > Medical Claims Officer

Job Description

The Medical Claims Officer is responsible for handling and processing medical and employee benefit claims, ensuring accurate documentation, timely follow-up, and excellent client service. The role acts as a key liaison between clients, hospitals, TPAs, and insurance companies to ensure smooth claim settlement and resolution.

Key Responsibilities

  • Review and process medical, life, and workmen compensation claims.
  • Serve as the main point of contact for clients and insurance providers regarding claims and coverage inquiries.
  • Follow up on pending claims to ensure timely settlement and reimbursement.
  • Provide clients with clear information on coverage, deductibles, copayments, and claim procedures.
  • Prepare and maintain accurate claims records, reports, and documentation.
  • Coordinate renewals, additions, deletions, and other policy updates.
  • Ensure high levels of customer satisfaction through prompt and professional communication.

Requirements

  • Bachelor’s degree in Business Administration, Insurance, or a related field.
  • 0-2 years of experience in medical claims or insurance.
  • Strong attention to detail and organizational skills.
  • Good communication and client servicing abilities.
  • Proficiency in MS Office (Excel is a plus).

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