We are seeking a detail-oriented and analytical Claims Administrator to join our client's team. The ideal candidate will have a solid background in nursing, health administration, or claims administration for travel insurance, and will be responsible for managing and processing insurance claims efficiently while delivering excellent customer service.
Key Responsibilities:
- Ensure the qualification of cases (emails) in our Salesforce tool.
- Fill in cases (Salesforce emails) with the necessary information to link the email to the insured/underwriter's environment.
- Fill in the subject of the emails.
- Dispatch cases (Salesforce emails) according to the services and the organization of the management services, and close certain cases.
- Deliver excellent customer service through high-quality and efficient handling of policyholder claims.
- Understand clients' needs, eligibility, and coverage, and provide qualified assistance services accordingly.
- Manage cases proactively using our internal systems and communicate with all relevant departments.
- Formulate, affect, interpret, or implement policies pertaining to strategic claim resolution.
- Make prompt and timely decisions on policy cover and settlement costs.
- Acquire information as necessary to perform accurate redress calculations.
- Achieve set targets in line with required quality standards.
Essential Job Functions:
- Assist and support claims head on project management, team management, and loss prevention.
- Manage claims for Health/PA, individual and group policies.
- Process Accident & Health claims according to SOPs and SLAs.
- Review customer claims documents and assess eligibility based on insurance terms and conditions.
- Investigate suspicious medical claims and collaborate with internal and external stakeholders.
- Process claims payments to customers and hospitals in a timely manner.
- Provide customer assistance and handle customer/broker inquiries.
- Address complaints escalated by Customer Service, Marketing, or Regulatory.
- Review claims processes and propose improvements, reporting process issues that need further development.
- Oversee Claim’s customer services to ensure the best customer experience at each stage of claims.
Requirements:
- Bachelor's degree.
- 1 year of previous experience in nursing, health administration, or claims administration for travel insurance.
- Fluent in both written and spoken English and Korean.
- Flexibility, adaptability, and a positive mindset are key values for this role.
- Excellent communication, interpersonal, detail-oriented and analytical skills.
- Proficient in using computers, Microsoft Office, Internet, and Email.
- Strong analytical and problem-solving skills.
- Ability to adapt and work well in a multicultural environment.
- Strong multitasking abilities.
Job Types: Full-time, Permanent
Pay: Up to 3,000,000원 per month
Application Question(s):
- What is your last drawn monthly gross basic salary in KRW?
- What is your expected monthly gross basic salary in KRW?
- How long is your notice period (in days)?
Experience:
- claim admin (travel insurance): 1 year (Required)
Language:
- native Korean (Required)
- average/ excellent English (Required)
Work Location: In person
