Description

JOB DESCRIPTION

Role Purpose
The Accident and Health Claims Adjuster is responsible
for the review, assessment, and management of A&H claims in a timely, fair, and accurate manner, ensuring compliance with policy terms, regulatory requirements and customer service standards..
Key Responsibilities
• Review and analyze A&H claims to determine coverage and eligibility under policy terms.
• Communicate with policyholders, brokers, healthcare providers, and internal stakeholders to obtain necessary information and provide claim updates.
• Make timely decisions on claim approval, partial payment, or denial with clear justifications.
• Identify potential fraudulent claims and refer cases as necessary for investigation.


Requisition #: 25202

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