440 Claims Processing jobs in Vietnam
Senior Claims Examiner
350000 Nam Dinh , Nam Dinh
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Posted 1 day ago
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Job Description
Our client is seeking a detail-oriented and experienced Senior Claims Examiner to join our insurance team. This role is vital for ensuring the accurate and efficient processing of insurance claims, upholding policy terms, and providing excellent service to our policyholders. You will be responsible for reviewing claims documentation, verifying coverage, determining liability, and authorizing payments within defined guidelines. The ideal candidate possesses a strong understanding of insurance policies, claims procedures, and regulatory compliance. This position requires excellent analytical, decision-making, and communication skills, with the ability to manage a caseload effectively and collaborate with internal and external stakeholders. This role will involve a hybrid work arrangement, balancing remote responsibilities with occasional office presence.
Key Responsibilities:
Qualifications:
Key Responsibilities:
- Review and evaluate insurance claims for accuracy, completeness, and compliance with policy provisions.
- Investigate claims by gathering necessary information, interviewing claimants, and obtaining supporting documentation.
- Determine coverage eligibility based on policy terms, conditions, and endorsements.
- Assess liability and damages associated with claims.
- Negotiate settlements with claimants or their representatives when appropriate.
- Process claim payments accurately and in a timely manner.
- Maintain detailed and organized claim files, ensuring all actions and decisions are well-documented.
- Adhere to all company claims handling procedures and regulatory requirements.
- Identify potential subrogation or salvage opportunities.
- Respond to inquiries from policyholders, agents, and other parties regarding claim status.
- Provide guidance and support to junior claims personnel.
- Stay current with industry best practices and changes in insurance regulations.
Qualifications:
- Bachelor's degree in Business, Finance, Law, or a related field.
- Minimum of 4-6 years of experience in claims examination or a similar role within the insurance industry.
- Strong knowledge of insurance policies, claims handling procedures, and relevant regulations.
- Excellent analytical, investigative, and problem-solving skills.
- Proficiency in claims management software and tools.
- Strong written and verbal communication skills, with the ability to negotiate effectively.
- Detail-oriented with excellent organizational and time management abilities.
- Ability to work independently and manage a caseload efficiently in a hybrid work environment.
- Professional insurance designations (e.g., Associate in Claims - AIC, Chartered Property Casualty Underwriter - CPCU) are a strong plus.
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Remote Claims Examiner - Health Insurance
410000 Hoang Hoa
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Posted 2 days ago
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Job Description
Our client is looking for meticulous and experienced Remote Claims Examiners to manage health insurance claims. This fully remote role is crucial for ensuring the accurate and efficient processing of medical claims, verifying coverage, and processing payments. You will be the primary point of contact for healthcare providers and members regarding claim status and inquiries, working entirely from a remote location.
Responsibilities include:
The ideal candidate will have a Bachelor's degree or equivalent experience in healthcare administration, medical billing and coding, or a related field. A minimum of 4 years of experience in processing health insurance claims is required. Thorough knowledge of medical terminology, insurance policies, and claims processing systems is essential. Proficiency in medical coding (ICD-10, CPT, HCPCS) is a must. Strong analytical skills, attention to detail, and the ability to work independently in a remote environment are critical. Excellent communication and customer service skills are necessary for interacting with providers and members. If you are a dedicated Claims Examiner seeking a flexible, remote opportunity in the health insurance sector, we encourage you to apply.
Responsibilities include:
- Reviewing and processing medical claims submitted by healthcare providers, ensuring accuracy and completeness.
- Verifying patient eligibility and insurance coverage based on policy details.
- Interpreting medical codes (ICD-10, CPT) and applying them correctly to claims.
- Identifying and investigating discrepancies, errors, or potential fraud in claims.
- Authorizing or denying claims based on policy provisions, medical necessity, and regulatory guidelines.
- Calculating and processing payments to providers according to fee schedules and contracts.
- Responding to inquiries from healthcare providers and members regarding claim status and explanations of benefits.
- Maintaining accurate and organized claim files in the company's claims processing system.
- Ensuring compliance with all relevant healthcare regulations, including HIPAA.
- Identifying trends in claims data and providing feedback for process improvement.
- Collaborating with other departments, such as appeals and verification, as needed.
The ideal candidate will have a Bachelor's degree or equivalent experience in healthcare administration, medical billing and coding, or a related field. A minimum of 4 years of experience in processing health insurance claims is required. Thorough knowledge of medical terminology, insurance policies, and claims processing systems is essential. Proficiency in medical coding (ICD-10, CPT, HCPCS) is a must. Strong analytical skills, attention to detail, and the ability to work independently in a remote environment are critical. Excellent communication and customer service skills are necessary for interacting with providers and members. If you are a dedicated Claims Examiner seeking a flexible, remote opportunity in the health insurance sector, we encourage you to apply.
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1
Remote Insurance Claims Analyst
20000 Haiphong , Haiphong
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Posted today
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Our client is seeking a detail-oriented and analytical Remote Insurance Claims Analyst to join their growing team. In this fully remote position, you will be responsible for investigating, evaluating, and resolving insurance claims in a fair and efficient manner. You will work closely with policyholders, claimants, and other stakeholders to gather necessary information, assess liability, and determine coverage under various insurance policies. This role requires a thorough understanding of insurance principles, claims processing procedures, and relevant legal and regulatory requirements. You will need to communicate effectively with all parties involved, clearly explaining policy terms and claim decisions. Your analytical skills will be crucial in reviewing documentation, identifying fraudulent activities, and negotiating settlements. The ideal candidate will possess strong organizational skills to manage a caseload of claims, ensuring timely processing and resolution. Experience with digital claims management systems and a commitment to providing excellent customer service are essential. This is an excellent opportunity to build a career in the insurance sector within a flexible, remote work environment.
Key Responsibilities:
Key Responsibilities:
- Investigate and evaluate insurance claims to determine coverage and liability.
- Gather and review all relevant documentation, including police reports, medical records, and policy details.
- Communicate clearly and professionally with policyholders, claimants, witnesses, and other relevant parties.
- Analyze claim information to identify potential fraud or misrepresentation.
- Calculate claim payouts and process payments according to policy terms and company procedures.
- Negotiate settlements with claimants and legal representatives when appropriate.
- Maintain accurate and detailed records of all claim activities and communications.
- Ensure compliance with all applicable insurance laws and regulations.
- Provide exceptional customer service throughout the claims process.
- Collaborate with underwriting and legal departments as needed.
- Bachelor's degree in Business Administration, Finance, Law, or a related field, or equivalent work experience.
- Proven experience in insurance claims handling, property & casualty, or related fields.
- Strong understanding of insurance policies, coverage, and claims investigation techniques.
- Excellent analytical, critical thinking, and problem-solving skills.
- Exceptional written and verbal communication and interpersonal skills.
- Proficiency in claims management software and standard office applications.
- Ability to work independently and manage time effectively in a remote setting.
- Attention to detail and a commitment to accuracy.
- Relevant insurance certifications are a plus.
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2
Remote Senior Claims Analyst - Insurance
210000 Phuong Son
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Posted 2 days ago
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Our client is seeking a highly analytical and experienced Remote Senior Claims Analyst to join their innovative insurance division. This position is fully remote, offering flexibility and the chance to contribute to a leading insurance company from the comfort of your home office. You will be responsible for examining, evaluating, and processing a wide range of insurance claims, ensuring accuracy, compliance, and adherence to company policies and industry regulations. Your expertise will be crucial in identifying potential fraud, assessing claim validity, and negotiating settlements. This role requires a deep understanding of insurance principles and practices, as well as strong analytical and problem-solving skills. Key responsibilities include conducting in-depth reviews of claim documentation, performing data analysis to identify trends and patterns, and collaborating with adjusters, legal counsel, and other departments to resolve complex claims. You will also be involved in developing and implementing claims handling procedures, providing training to junior staff, and contributing to the continuous improvement of the claims process. The ideal candidate will possess a bachelor's degree in Business Administration, Finance, or a related field, coupled with a minimum of 6 years of experience in insurance claims processing and analysis. Certifications such as AIC or CPCU are highly desirable. Excellent written and verbal communication skills are essential, as you will be communicating with policyholders, claimants, and internal teams. Strong organizational skills and the ability to manage multiple priorities in a remote setting are paramount. We are looking for a detail-oriented professional who can work independently and make sound judgments. If you are passionate about the insurance industry and looking for a challenging and rewarding remote career opportunity, this is the perfect role for you. Apply now to become a vital part of our client's dedicated claims team.
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3
Senior Claims Analyst - Remote Specialist
20000 Phuong Son
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Posted today
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Job Description
Our client is seeking a meticulous and analytical Senior Claims Analyst to join their esteemed insurance team. This is a fully remote position, providing a flexible work environment for talented individuals nationwide. In this role, you will be responsible for evaluating, processing, and resolving complex insurance claims with accuracy and efficiency. You will ensure compliance with company policies and industry regulations, providing exceptional service to policyholders and stakeholders. Your ability to interpret policy documents, assess damages, and negotiate settlements will be key to your success.
Responsibilities include:
The successful candidate will possess a deep understanding of insurance principles and claims processing. Excellent analytical, problem-solving, and decision-making skills are essential. Strong communication and negotiation abilities, coupled with a commitment to customer service, are highly valued. A bachelor's degree in a related field or equivalent experience is required. Prior experience in claims handling, particularly in a remote capacity, is a significant advantage. This role requires a high degree of integrity, attention to detail, and the ability to work independently.
Responsibilities include:
- Reviewing and analyzing insurance claim submissions for accuracy and completeness.
- Investigating claims by gathering necessary information, documentation, and evidence.
- Determining coverage eligibility and liability based on policy terms and conditions.
- Calculating claim payouts and negotiating settlements with claimants and legal representatives.
- Communicating claim status and decisions to claimants, agents, and other parties involved.
- Maintaining detailed and accurate records of all claim activities in the system.
- Identifying potential fraud indicators and escalating suspicious claims for further investigation.
- Ensuring compliance with all relevant state and federal regulations.
- Providing guidance and support to junior claims adjusters and processors.
- Contributing to the development and refinement of claims handling procedures.
The successful candidate will possess a deep understanding of insurance principles and claims processing. Excellent analytical, problem-solving, and decision-making skills are essential. Strong communication and negotiation abilities, coupled with a commitment to customer service, are highly valued. A bachelor's degree in a related field or equivalent experience is required. Prior experience in claims handling, particularly in a remote capacity, is a significant advantage. This role requires a high degree of integrity, attention to detail, and the ability to work independently.
This advertiser has chosen not to accept applicants from your region.
4
Senior Healthcare Claims Analyst - Remote
60000 Pleiku, Gia Lai
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Posted 2 days ago
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Job Description
Our client, a leading entity in the healthcare sector, is seeking a highly skilled Senior Healthcare Claims Analyst to join their fully remote team. This critical role involves the meticulous review, adjudication, and analysis of complex medical claims. You will play a vital part in ensuring the accuracy and integrity of claims processing, identifying fraudulent activities, and contributing to the financial health of our operations. The ideal candidate will possess a strong background in medical coding, insurance principles, and regulatory compliance, coupled with exceptional analytical acumen.
Key Responsibilities:
Key Responsibilities:
- Review and adjudicate high-volume, complex medical insurance claims in accordance with company policies, benefit plans, and regulatory guidelines.
- Analyze claims data to identify patterns, trends, and anomalies indicative of errors, overpayments, or potential fraud.
- Investigate and resolve claims issues, collaborating with providers, members, and internal departments as necessary.
- Interpret medical policies, EOBs (Explanation of Benefits), and provider contracts to ensure correct claim processing.
- Provide guidance and mentorship to junior claims analysts, fostering a culture of accuracy and efficiency.
- Contribute to the development and refinement of claims processing procedures and guidelines.
- Prepare detailed reports on claims analysis, findings, and recommendations for process improvements.
- Stay current with changes in healthcare regulations, coding updates (e.g., ICD-10, CPT), and insurance industry best practices.
- Maintain confidentiality and adhere to data privacy regulations (e.g., HIPAA, relevant Vietnamese data protection laws).
- Bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field.
- Minimum of 5 years of experience in health insurance claims processing, medical billing, or healthcare administration.
- In-depth knowledge of medical coding systems (ICD-10, CPT, HCPCS) and insurance terminology.
- Proficiency in claims adjudication software and healthcare IT systems.
- Strong analytical and problem-solving skills, with meticulous attention to detail.
- Excellent written and verbal communication skills.
- Ability to work independently and manage time effectively in a remote work environment.
- Understanding of healthcare regulations and compliance requirements.
- Relevant certifications (e.g., CPC, CHFP) are a plus.
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5
Insurance Claims Adjuster
500000 An Thanh
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Posted today
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Job Description
Our client, a leading insurance provider, is looking for a detail-oriented and empathetic Insurance Claims Adjuster to join our fully remote claims processing team. This role is pivotal in ensuring fair and efficient settlement of insurance claims. You will be responsible for investigating claims, assessing damages, determining coverage, and negotiating settlements with policyholders and third parties. The ability to manage a caseload effectively, conduct thorough investigations (often via remote communication and digital evidence), and maintain excellent customer service standards is crucial. We seek professionals with strong analytical skills and a commitment to ethical practices in a remote work setting.
Responsibilities:
Qualifications:
Responsibilities:
- Investigate insurance claims by gathering relevant information, including police reports, witness statements, and property damage assessments.
- Analyze policy coverage to determine the extent of the company's liability.
- Assess the value of damaged property or the extent of injuries, using industry standards and expert opinions.
- Negotiate claim settlements with policyholders and other involved parties in a fair and timely manner.
- Prepare detailed reports documenting claim investigations, findings, and settlement recommendations.
- Maintain accurate and organized claim files using digital systems.
- Communicate effectively with policyholders, claimants, attorneys, and other stakeholders throughout the claims process.
- Ensure compliance with all relevant insurance regulations and company policies.
- Identify potential fraud indicators and escalate suspicious claims for further investigation.
- Manage a caseload of claims efficiently, prioritizing tasks and meeting deadlines.
- Utilize remote tools for virtual inspections, client communication, and documentation.
- Stay updated on industry trends, legal requirements, and best practices in claims adjusting.
Qualifications:
- Proven experience as a Claims Adjuster or in a similar insurance role.
- In-depth knowledge of insurance policies, claims procedures, and relevant regulations.
- Strong analytical and investigative skills.
- Excellent negotiation and conflict-resolution abilities.
- Proficiency in using claims management software and digital documentation tools.
- Exceptional communication and interpersonal skills for effective remote interaction.
- Ability to work independently and manage time effectively in a remote environment.
- High school diploma or equivalent required; Bachelor's degree in a related field is a plus.
- Relevant insurance licenses or certifications are highly desirable.
- Attention to detail and a commitment to accuracy.
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6
Insurance Claims Adjuster
50000 Thuy Van
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Our client, a reputable insurance provider, is looking for a diligent and experienced Insurance Claims Adjuster to manage and process insurance claims in Hue, Thua Thien–Hue, VN . This role involves investigating insurance claims, determining the extent of the company's liability, and negotiating settlements with claimants. You will be responsible for interviewing claimants and witnesses, inspecting damaged property, reviewing police reports and other relevant documents, and analyzing claim details to ensure compliance with policy terms and conditions. The ideal candidate will have a strong understanding of insurance policies, claims procedures, and relevant legal and regulatory requirements. Excellent investigative, analytical, and negotiation skills are essential. You must be able to manage a caseload efficiently, maintain accurate records, and communicate effectively and empathetically with clients during what can be a difficult time. Experience in property and casualty insurance claims is highly preferred, along with relevant industry certifications. This position offers a blend of office-based work and field visits, providing a dynamic work environment. If you are a detail-oriented professional with a commitment to fairness and integrity, seeking a challenging and rewarding career in the insurance industry, we encourage you to apply.
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7
Insurance Claims Adjuster
34000 Thai Binh , Thai Binh
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Job Description
Our client, a reputable insurance provider, is seeking a diligent and detail-oriented Insurance Claims Adjuster to join their team in Thai Binh, Thai Binh, VN . This role is pivotal in assessing and processing insurance claims efficiently and fairly, ensuring customer satisfaction and adherence to company policies and regulatory standards. You will be responsible for investigating insurance claims, determining coverage, and negotiating settlements with policyholders and claimants. The ideal candidate will possess strong analytical skills, excellent communication abilities, and a thorough understanding of insurance policies and claims procedures. Your duties will include interviewing claimants and witnesses, inspecting damaged property, and reviewing documentation such as police reports and medical records. You will analyze claim data to determine liability and assess the extent of damages. Negotiating settlements within established guidelines and ensuring prompt and accurate payment of approved claims will be key responsibilities. Maintaining detailed and organized claim files, documenting all activities and communications, is essential. You will also be responsible for identifying potential fraud and escalating suspicious claims for further investigation. Staying up-to-date with relevant laws, regulations, and industry best practices is a must. Collaboration with legal counsel, repair shops, and other parties involved in the claims process will be necessary. A bachelor's degree in Business Administration, Finance, Law, or a related field is preferred, along with a minimum of 3 years of experience in insurance claims handling. Proven experience in property, auto, or casualty claims is advantageous. Excellent negotiation, communication, and interpersonal skills are required. Strong analytical and problem-solving abilities are essential. Proficiency in claims management software is a plus. This hybrid role requires the ability to work both from our office in Thai Binh, Thai Binh, VN and remotely, balancing on-site assessments with home-based administrative tasks.
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8
Insurance Claims Adjuster
550000 Hoa Sơn
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Posted today
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Our client is seeking a diligent and detail-oriented Insurance Claims Adjuster to join their team in Da Nang, Da Nang, VN . This role is crucial for evaluating insurance claims, determining coverage, and facilitating fair settlements for policyholders. You will investigate insurance claims by gathering information through interviews, reviewing documents, and inspecting damaged property or vehicles. Key responsibilities include analyzing policy coverage, assessing the extent of damages or losses, and negotiating settlements with claimants. The ideal candidate possesses strong analytical and critical thinking skills, excellent communication and interpersonal abilities, and a high degree of integrity. Experience in the insurance industry, particularly in claims handling, is essential. You will need to maintain accurate and thorough documentation of all claims activities, ensuring compliance with company policies and regulatory requirements. The ability to work independently, manage a caseload efficiently, and make sound judgments under pressure is critical. You will interact with policyholders, witnesses, and legal professionals. This position offers a stable career path and the opportunity to help people during challenging times. A bachelor's degree in Business, Finance, or a related field is preferred. Relevant insurance certifications or licenses are highly advantageous. A minimum of 3 years of experience as a claims adjuster or in a related insurance role is required. Proficiency in claims management software is a must. If you are a professional with a keen eye for detail and a commitment to customer service, we encourage you to apply.
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