12 дней назад
Claims Specialist - Claims Adjudicator (Life & Health)
Вакансия из Hirify Global, списка международных tech-компанийДля мэтча и отклика нужен Plus
Мэтч & Сопровод
Для мэтча с этой вакансией нужен Plus
Описание вакансии
Текст:
TL;DR
Claims Specialist - Claims Adjudicator (Life & Health): Assessing and managing assigned Life & Health insurance and reinsurance claims in Mexico City with an accent on medical, financial, occupational, and contractual information review. Focus on documenting claim decisions, monitoring portfolios, supporting clients and stakeholders, and escalating complex cases within delegated authority.
Location: Mexico City, Mexico
Company
provides reinsurance, insurance, and insurance-based risk transfer solutions, with a focus on improving resilience and managing complex risks.
What you will do
- Assess and manage assigned Life & Health claims within delegated authority and established guidelines.
- Review medical, financial, occupational, and contractual information and document claim decisions.
- Identify missing information, maintain accurate claim records, and escalate complex or unusual claims.
- Support client discussions, claim reviews, inquiries, training activities, and service initiatives.
- Monitor claims data and trends, contribute to reports, audits, quality reviews, and process improvements.
- Collaborate with Claims, Underwriting, Pricing, Medical, Client Markets, and Operations teams.
Requirements
- Experience in insurance, claims, customer service, underwriting support, healthcare, legal, or a related field.
- Strong analytical, problem-solving, organizational, communication, and attention-to-detail skills.
- Ability to manage multiple priorities, apply sound judgment, and build effective working relationships.
- Interest in developing technical Life & Health claims assessment capabilities.
- Intermediate English proficiency required.
Nice to have
- Exposure to Life & Health insurance products or claims documentation.
- Familiarity with claims systems, workflow tools, data analysis, or reporting.
- Background in insurance, health, legal, nursing, rehabilitation, or business studies.
- Progress toward professional insurance designations or industry certifications.
- Basic Portuguese.
Culture & Benefits
- Collaborative work with experienced claims professionals and cross-functional stakeholders.
- Training, coaching, knowledge sharing, and continuous improvement opportunities.
- Inclusive and flexible environment supporting equal professional development opportunities.
- AI-powered tools may support application review, with final hiring decisions reviewed by people.
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