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Working Arrangement
Hybrid
Job Description
Are you looking for a supportive and collaborative workplace with great benefits and clear career development You've come to the right place.
Why choose Manulife
- Competitive Salary packages and performance bonuses
- Day 1 HMO + FREE coverage for your dependents (inclusive of same-sex partners)
- Retirement savings benefit
- Rewarding culture that values wellness and well-being
- Performance Bonus
- Global network of industry experts
- Extensive training resources
Job Description:
The Medical Claims Adjudicator is responsible for being the primary contact to gather all company, legal and regulatory requirements to process claims, while maintaining the highest level of professionalism and customer satisfaction.
Have the skills and knowledge for the job Learn more about the opening below!
Key Responsibilities:
- Manage all aspects of the claim process
- Adjudicate non-complex claims according to established guidelines and standards as well as state legislation
- Determine appropriate requirements
- Analyze and interpret claim documentation, policy contract wording and in-force policy documentation to establish whether the claim is complete and valid, correct death benefit and correct beneficiary
- Make claim decisions within approval limits
- Make disbursements on valid claims to the correct beneficiary for the correct claim amount
- Communicate and collaborate with the field and head office colleagues to provide the highest quality and service levels to customers
- Handle other issues or requirements related to the claim such as check stop pay and reissue
- Ability to adapt to changing regulatory requirements affecting claim practices and apply new approaches specifically, claims and endowments; annual due diligence address cleanse, process pre-escheatment claim payments
- Process accounting as required Assist in identifying and providing solutions to work related problems and issues (ie. work flow, systems)
- Communicate with claimants or their legal representatives as required
- Comply with complex state legislative requirements in terms of claims practices and report any fraudulent activities to the appropriate sources
- Comply with departmental procedures
- Actively participate in claims department projects that improve effectiveness and efficiency
- Other duties as assigned
Qualifications:
- At least one (1) year of relevant work experience in medical claims
- Detailed knowledge of medical claims function
- Fresh Graduates of a healthcare or allied health degree without work experience are welcome to apply
- Sound knowledge of insurance beneficiaries
- General knowledge of referral areas
- Minimum Skills to Hire/Must Haves:
- Proficiency in Microsoft Office applications tools especially on Word in Macro (Word, PowerPoint, Excel)
- Excellent and efficient keyboarding skills
- Proficient in writing and verbal communication skills and business correspondence
- Efficient time management and multi-tasking skills with strong attention to details
- Strong critical thinking skills as to comprehend and analyze documents and requests
- Strong customer service orientation
- Mandarin proficiency in reading and writing is a plus.
Let's make every day better together. Learn about our opportunities at JOBS.MANULIFE.COM
About Manulife And John Hancock
Manulife Financial Corporation is a leading international financial services group that helps people make their decisions easier and lives better. With our global headquarters in Toronto, Canada, we operate as Manulife across our offices in Asia, Canada, and Europe, and primarily as John Hancock in the United States. We provide financial advice, insurance, and wealth and asset management solutions for individuals, groups and institutions. At the end of 2022, we had more than 40,000 employees, over 116,000 agents, and thousands of distribution partners, serving over 34 million customers. At the end of 2022, we had $1.3 trillion (US$1.0 trillion) in assets under management and administration, including total invested assets of $0.4 trillion (US $0.3 trillion), and segregated funds net assets of $0.3 trillion (US$0.3 trillion). We trade as MFC on the Toronto, New York, and the Philippine stock exchanges, and under 945 in Hong Kong.
Manulife is an Equal Opportunity Employer
At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.
It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact [Confidential Information].
