Health Claims Query Administrator
Diego-Martin or Westmoorings, North West
Full time
Posted On 04.16.2025
Expire On 05.17.2025 Employer
Description
Are you a strong communicator with a sharp eye for detail and a passion for helping others? We’re looking for a proactive and organized Health Claims Query Administrator to support our claims processing team.
About Guardian Life of the Caribbean Limited
Guardian Life of the Caribbean Limited leads the charge in Life, Health, and Pension solutions throughout the Caribbean Region. Our unwavering mission is to cultivate financial freedom for our stakeholders through transformative interactions, fuelled by the relentless power of technology. With innovation at our core, we strive to redefine the landscape of financial services, empowering individuals, and businesses alike to pursue their dreams with confidence and security.
JOB OVERVIEW:
The objectives of the Health Claims Query Administrator is to ensure the provision of prompt and accurate health claims administrative support inclusive of the efficient management of the claims payment generation processes for the Trinidad and Regional Territory portfolios. To provide efficient, accurate and effective back-office support to customer service for satisfaction of both internal and external clients on a timely basis.
JOB RESPONSIBILITIES:
- QUERY MANAGEMENT
- To review and respond accurately and in accordance with the established turnaround time to queries submitted by Customer Service.
- PAYMENTS
- To ensure the prompt and timely execution of the payment generation process on a daily basis inclusive of performing all necessary pre-validation checks.
- RECOVERIES, RECONCILIATION AND CLAIMS SETTLEMENTS
- Performance of Reconciliations and management of the Recoveries process.
- Maintenance of floats for Regional Agencies for their facilitation of the health claims settlement process.
- CORRESPONDANCE AND PRE-CERTIFICATION
- To review, allocate, prepare and disseminate client correspondence inclusive of but not limited to pre-certifications/estimates.
- To perform any other job-related duties as assigned by the Team Leader and Manager.
EDUCATION & EXPERIENCE:
- 5 C.X.C. / CSEC passes including English Language and Mathematics.
- 2 A’ Level / CAPE passes.
- LOMA 280, 290 and related parts ACS 100.
- Certificate/Diploma in Business and/or Basic Accounting Principles
- Certificate in Customer Service
- At least 2 years' work experience in a Health Claims environment
- At least 1 year work experience in a customer service environment
ADDITIONAL REQUIREMENT:
- As a regulated entity with obligations under the Know Your Employee guidelines, a Certificate of Character is required.
PERSON SPECIFICATION:
The Health Claims Query Administrator must be able to work with minimum supervision. He/ She must be very dedicated, trustworthy and must display strong work ethics. The incumbent must possess excellent analytical and written communication skills, must be flexible and proactive in their approach to their duties.
Applications will be treated with the utmost confidentiality.
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Overview
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Job Requirements
EDUCATION & EXPERIENCE:
- 5 C.X.C. / CSEC passes including English Language and Mathematics.
- 2 A’ Level / CAPE passes.
- LOMA 280, 290 and related parts ACS 100.
- Certificate/Diploma in Business and/or Basic Accounting Principles
- Certificate in Customer Service
- At least 2 years' work experience in a Health Claims environment
- At least 1 year work experience in a customer service environment
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