Healthcare Services & Claims Specialist

Triple-S Management Corp.; San Juan (PR); Hybrid; USD 36.000 - 56.000; Vollzeit

Zusammenfassung

Triple-S Management Corp. in Puerto Rico is seeking a health services underwriting support professional to perform non-routine tasks under supervision, assisting with health service underwriting, renewal and claims processes.

You will apply various procedures and guidelines and may train others as needed. Responsibilities include handling product requests, coordinating with other departments, drafting documents in English and Spanish, and supporting audits and reports.

Qualifikationen

• Associate's Degree in Business Administration or Marketing.
• Experience: 1 year of experience related to configuration processes, preferred.
• Alternatively, High School Diploma with at least 3 years of experience in configuration processes.

Aufgaben

• Supports and guides customers who visit or call to handle product requests for health coverage and other policies.
• Processes required petitions to complete transactions such as payments, maintenance, subscriptions, refunds, claims, letters, certifications, activations, cancellations, pharmacy, and grievances.
• Analyzes and investigates customer requests, coordinating with other departments to resolve cases.
• Evaluates and determines actions to take on client requests according to applicable laws.
• Researches and drafts documents in English and Spanish when required.
• Assists Supervisor/Manager/Director in meetings, report preparation, audits or related tasks.

Jobbeschreibung

Triple-S Management Corp. in Puerto Rico is seeking a health services underwriting support professional to perform non-routine tasks under supervision, assisting with health service underwriting, renewal and claims processes.

You will apply various procedures and guidelines and may train others as needed. Responsibilities include handling product requests, coordinating with other departments, drafting documents in English and Spanish, and supporting audits and reports.