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Claims Service Officer - Medical Coding

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QBE Insurance

Jan 9, 2025

  • Job
    Full-time
    Entry Level
  • Customer Relations
  • Manila
  • Quick Apply

AI generated summary

  • You need a Bachelor’s degree or equivalent, customer service skills, MS proficiency, analytical abilities, and strong communication. AIS certification and basic insurance knowledge preferred.
  • You will ensure compliance with policies, handle customer queries, settle fast track claims, identify recovery and fraud opportunities, and manage efficient call communication.

Requirements

  • Required Education
  • • Bachelor's Degree or equivalent combination of education and work experience
  • Required Experience
  • • NA
  • Preferred Competencies/Skills
  • • Customer service skills
  • • Proficiency in MS tools
  • • Analytical and negotiation skills
  • • Excellent verbal and written communication skills (English)
  • • Preferably with Case Management Skills
  • Preferred Licenses/Certifications
  • • Abbreviated Injury Scale (AIS) certification is preferred but can also be taken as part of training
  • Preferred Knowledge
  • • Preferred Basic Knowledge of Insurance
  • • Basic Knowledge of Customer Service

Responsibilities

  • Ensure compliance with QBE policies, procedures and relevant legislations and regulations
  • Ensure compliance within delegated authority limits
  • Adherence to triage/ transfer guidelines
  • Provide feedback to claims handler on necessary action/ activity on claim
  • Maintain effective communication with customers
  • Accurately and completely respond to customer’s queries on claims/ on a specific claim
  • Settle fast track claims where invoices are already made available by customer at the onset.
  • Identify recovery opportunities on claims
  • Identify suspicious or potentially fraudulent claims in accordance with QBE fraud indicators. Refer these claims to the Fraud Investigations team.
  • Control the call to ensure efficiency in call handling

FAQs

What is the job title for this position?

The job title for this position is Claims Service Officer - Medical Coding.

What are the main responsibilities of the Claims Service Officer?

The main responsibilities include managing frontline customer contacts, resolving customer concerns, settling fast track claims, identifying recovery and fraud opportunities, and maintaining effective communication with customers.

What educational qualifications are required for this role?

A Bachelor's Degree or an equivalent combination of education and work experience is required.

Is previous experience necessary for this position?

No prior experience is required for this role.

What skills are preferred for candidates applying for this position?

Preferred skills include customer service skills, proficiency in MS tools, analytical and negotiation skills, and excellent verbal and written communication skills in English.

Are there any preferred certifications for this role?

Yes, an Abbreviated Injury Scale (AIS) certification is preferred but can also be taken as part of training.

What kind of knowledge is preferred for this position?

Preferred knowledge includes basic understanding of insurance and basic customer service.

What is QBE’s approach to employee conduct?

QBE expects all employees to adhere to its Code of Ethics and Conduct and apply sound risk management practices.

What type of job classification is this position?

This position is classified as an Individual Contributor role.

How can candidates apply for this job?

Candidates can apply by clicking "Apply" and following the step-by-step process.

Does QBE offer equal employment opportunities?

Yes, QBE is an equal opportunity employer and complies with equal employment opportunity legislation in each jurisdiction in which it operates.

What does QBE expect from its employees regarding company culture?

QBE expects employees to role model and inspire behaviors that link to its cultural elements, which include being customer-focused, technical experts, inclusive, fast-paced, courageous, accountable, and collaborative.

Are reasonable accommodations available for individuals with disabilities?

Yes, reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.

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QBE Insurance

Finance
Industry
10,001+
Employees
1886
Founded Year

Mission & Purpose

QBE is an international insurer and reinsurer listed on the Australian Securities Exchange and headquartered in Sydney. We employ around 13,000 people in 27 countries. Leveraging our deep expertise and insights, QBE offers commercial, personal and specialty products and risk management solutions to help people and businesses manage risks, build strength and embrace change to their advantage.