Job Summary: Management and personalized support for VIP claims, policy review, and ensuring exceptional service for key clients in complex situations. Key Highlights: 1. Personalized VIP and key client claim management. 2. Direct intervention to expedite hospital discharges. 3. Experience in major medical expense and life insurance claims. **Description** --------------- **The Role** * Processing and personalized management of VIP or key client claims with insurers. * Client accompaniment—or coordination with HR departments—in complex or disputed claims requiring adjudication. * Comprehensive review of policy general conditions and endorsements, including medical-administrative validation of claim denials or client complaints for subsequent discussion with insurers. * Direct intervention with insurer claims departments regarding issues arising before, during, and up to hospital discharge of our clients receiving direct-pay services. * Activation, accompaniment, and follow-up with clients and insurers to expedite hospital discharges due to death, facilitating body release to the client’s family. * Management of discount benefit applications for our clients in claims deemed non-covered or rejected by insurers under direct-pay arrangements. * Processing and management of life insurance claims involving insurers, clients, and/or beneficiaries. * Conducting scheduled in-person visits for assigned clients. **Qualifications** ------------------ **Requirements** * Empathy, kindness, courtesy, strong interpersonal skills, active listening, service-oriented attitude, and ability to interact effectively with diverse employees and manage stressful situations. * Proactive and anticipatory mindset—capable of foreseeing potential issues or complications in claims resulting from insufficient client guidance or inadequate review of client-provided information. * Experience in processing, advising on, and handling major medical expense and life insurance claims within brokerages or insurance companies. * Intermediate proficiency in Microsoft Office (Excel, PowerPoint, Word). * Availability to address urgent matters regardless of time of occurrence. * Appropriate handling of complaints, disputes, and high-pressure situations, etc. * Effective communication and active listening skills. *Equal Employment Opportunity*
Juan García
Indeed · HR
Juan García
Indeed · HR
