Job Information
Claims Adjudicator Associate - Pre-Authorization
Company Information
Job Information
Company
Sagicor Jamaica
Website
https://www.sagicor.com/
Contact Name
Contact Email
sagicorjobs@careerjamaica.com
Job Type
Full-time
Department
Sagicor Life Jamaica Ltd.
Category
Computer/IT
Posted
14-04-2024
Job Status
Start Publishing
14-04-2024
Stop Publishing
20-04-2024
[Kingston,Jamaica ]
Description
"Looking for a diverse and rewarding career? If you're looking to grow your career within a stable and growing financial services company, then Sagicor may be right for you!"
Sagicor Life Jamaica Limited is seeking a suitable candidate to join our Group Insurance Services (Claims) team in the capacity of: Claims Adjudicator Associate - Pre-Authorization
- Examine requests for diagnostic and other medical procedures; give written approval for these procedures based on the available benefits.
- Preauthorize and pre-certify claims.
- Approve specific investigations, treatment, and or surgery ensuring that the company’s liability, given the facts presented, are clearly and accurately stated.
- Liaise with the Company’s Medical Director for approval of claims for pre-authorization, and surgery and where discrepancies arise, seek clarification and prepare written communication, with supervision from Senior Adjudicator, Pre-Authorization Unit, to the clients/ provider.
- Ensure that members are eligible for requested coverage.
- Inform Supervisor of cases which may require subrogation.
- Prepare productivity and other reports for submission to Supervisor, Pre-Authorization Unit.
- Perform other related duties assigned from time to time.
What do you need?
- Minimum of an Associate Degree in Business, Computing or equivalent qualification from a recognized institution.
- Three (3) years’ working experience in the Life Insurance industry in a similar capacity.
- Successful completion of HIA parts 1&2.
- Excellent oral and written communication skills.
- Good time management and client relations skills.
- Sound knowledge of software applications including spreadsheets and word processing applications.
- Working knowledge of Group Life and Health Insurance operations.
If this role is of interest to you, kindly submit an application via Sagicor's career portal no later than April 26, 2024.
While we appreciate all applications, only shortlisted candidates will be contacted.
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