Claims Exception Analyst (LER)

  • TCP Techlog Center Philippines
  • US-Work at Home
  • 1mo ago
  • Full-Time
  • Remote

ROLE PURPOSE

Claims Exception Analysts use a variety of accredited client and company guidelines to adjudicate claims exception requests effectively and efficiently. These include, but are not limited to, client billing systems and Asurion-specific tools for analyzing customer claims information and supporting documentation to ensure accuracy and authenticity. Claims Exception Analysts occasionally handle chats from internal customers for claim inquiries and escalations.

ESSENTIAL DUTIES AND RESPONSIBILITIES

· Primarily responsible for evaluating and adjudicating claim exception requests in adherence to established work instructions.

· Periodically responsible for adjudicating higher-risk exceptions not governed by established work instructions but supported through broader policies and agreements.

· Effectively track, log, and monitor claims you are working on.

· Navigate, prioritize, and execute client assignments in a fast-paced environment.

· Proven ability to monitor, identify, and flag emerging risk trends as necessary.

· Excellent verbal and written communication skills with internal and external partners.

· Maintain confidentiality of information related to customers, clients, and/or associates.

· Function as a resource to team members by answering and/or resolving policy questions, policy terms, program procedures, cancellation status inquiries, etc.

· Maintain accurate and proficient knowledge of products, policy terms and coverages, and program procedures.

· Research and review exception decisions to ensure validity and accuracy in accordance with program enrollment.

· Strong organizational skills to navigate ambiguity.

· Consistently achieve established team quality, productivity, and/or performance goals.

· Demonstrate willingness to perform additional tasks to support team initiatives as needed.

QUALIFICATIONS

· Possess or be willing to gain a valid Insurance License.

· Possess or be willing to gain a valid Home State Property & Casualty License.

· General proficiency with Microsoft Office tools.

· Willingness to work nights and/or weekend shifts.

ADDITIONAL ROLE CONSIDERATIONS

· Periods of standing, walking, and sitting for at least 8 hours daily.

· Perform assigned overtime hours based on business demand.

· Close vision, distance vision, color vision, depth perception, peripheral vision, and the ability to adjust focus visually.

· Eye-hand coordination and using hands to handle, feel, reach, or grasp.