Guardian Group

Health Claims Support Admin

Posted: 5 days ago

Job Description

Are you organized, detail-focused, and passionate about helping others navigate health claims? We’re seeking a proactive Health Claims Support Administrator to provide vital support in processing and managing health insurance claims. If you’re ready to make a difference in a fast-paced environment and build your career in healthcare administration, we want to hear from you!About Guardian Life Of The Caribbean LimitedGuardian Life of the Caribbean Limited leads the charge in Life, Health, and Pension solutions throughout the Caribbean Region. Our unwavering mission is to cultivate financial freedom for our stakeholders through transformative interactions, fuelled by the relentless power of technology. With innovation at our core, we strive to redefine the landscape of financial services, empowering individuals, and businesses alike to pursue their dreams with confidence and security.Job OverviewThe objectives of the Health Claims Support Administrator is to ensure the provision of prompt and accurate health claims administrative support inclusive of the efficient management of the claims payment generation processes for the Trinidad and Regional Territory portfolios. To provide efficient, accurate and effective back office support to customer service for satisfaction of both internal and external clients on a timely basis.Job ResponsibilitiesQuery Management To review and respond accurately and in accordance with the established turnaround time to queries submitted by Customer Service. Payments To ensure the prompt and timely execution of the payment generation process on a daily basis inclusive of performing all necessary pre-validation checks. Recoveries, Reconciliations and Claims Settlements Performance of Reconciliations and management of the Recoveries process. Maintenance of floats for Regional Agencies for their facilitation of the health claims settlement process. Correspondence and Pre-Certification To review, allocate, prepare and disseminate client correspondence inclusive of but not limited to pre-certifications/estimates. To perform any other job-related duties as assigned by the Team Leader and Manager.Education And Experience 5 C.X.C. / CSEC passes including English Language and Mathematics. 2 A’ Level / CAPE passes. LOMA 280, 290 and related parts ACS 100. Certificate/Diploma in Business and/or Basic Accounting Principles Certificate in Customer Service At least 2 years work experience in a Health Claims environment At least 1 year work experience in a customer service environmentAdditional RequirementAs a regulated entity with obligations under the Know Your Employee guidelines, a Certificate of Character is required.Person SpecificationThe Health Claims Support Administrator must be able to work with minimum supervision. He/ She must be very dedicated, trustworthy and must display strong work ethics. The incumbent must possess excellent analytical and written communication skills, must be flexible and proactive in their approach to their duties.Applications will be treated with the utmost confidentiality.

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