Claims Adjudication Associate – Manual Payment

Summary

Sagicor Life Jamaica Limited is seeking a suitable candidate to join our Insurance Operation Services - Claims team in the capacity of: Claims Adjudication Associate – Manual Payment Accurately adjudicate and issue payments for claims up to a limit of $50,000.

Responsibilities

• Adjudicate on all categories of payments for subscriber claims as required.:

  • • Input information related to the processing of all health claims including provider number, service, diagnosis codes and approve assigned categories of claims.
  • • Initiate payment of claims.
  • • Prepare required over-authorization forms for claims exceeding $50,000.
  • • Report questionable claims or claims with unusually high charges.
• • Prepare productivity reports for submission to supervisor.
• • Perform other job-related duties assigned from time to time.

Required Skills

• • Excellent oral and written communication skills.
• • Good time management and client relations skills.
• • Sound knowledge of software applications including spreadsheets and word processing applications.
• • Basic knowledge of medical terminologies.
• • Working knowledge of Group Life and Health Insurance operations.

Qualifications

• • Minimum of an Associate degree or equivalent qualification from a recognized institution.
• • Minimum of one (1) year working experience in processing Health Claims.
• • Successful completion of the HIA parts 1&2 designation would be an asset.

Additional Information and Instructions

📋 How to Apply: 🔹 If this role is of interest to you, kindly submit an application via Sagicor's career portal no later than January 10, 2025. 🙏 We appreciate all applications; however, only shortlisted candidates will be contacted.

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