Insurance Claim Verification and Control Checking Officer

Company Name: Guardian Life Insurance Limited


Roles & Responsibilities:

  • Complete pre-contract and post-contract checks of Group Life Contract to ensure robust systems are in place and implement recommendation.
  • Design and tailor the nature and the scope of verification work to address the size and nature of claims and uncover and address irregularities.
  • Regularly review settled life claims to ensure close oversight on the possible miss out of potential non-payable/manipulated claims.
  • Assess and verity potential manipulated claims and establish and maintain a risk register database of those organizations to determine the scope of the work required to define future potential mitigation requirements.
  • Be responsible for undertaking verification of claims and to ensure management control systems operate satisfactorily.
  • Complete regular claims checking and sampling for verification, and produce reports as necessary, highlighting areas of non-compliance or potentially ineligible claim settlement, detailing irregularities that will need reported to management committee for recovery action. Ensure sampling of claims in line with the contract and verify as specified in the agreement.
  • Managing claim related projects, developing and implementing new procedures for claims processing to drive forward continuous process improvement.
  • Coordinate audit functions with internal and external auditors as needed when needed.
  • Support the development and implementation of the Claim related policies.
  • Liaise with claim staff and a wide range of group customers, hospital networks and support the maintenance of positive client relationships.
  • Work in conjunction with other department staff to implement required controls are of mutual concern.
  • Liaise with the finance department for accurate and timely production of Management and Financial information. Ensuring robust processes and procedures are in place for accurate recording of data.
  • Demonstrate a high level of personal integrity and maintain professional standards throughout the organization
  • Deliver results against directorate and business objectives.

Educational Qualification:

  • At least Bachelor Degree in Business Administration or Finance from reputed University.

Work Experience:

  • 2 to 3 year(s)

Others Requirements:

  • Experience in related field will get the preference

Others Benefit:

Medical allowance, Performance bonus, Provident fund, Weekly 2 holidays, Insurance, Gratuity Lunch Facilities: Partially Subsidize Festival Bonus: 2

 

Source: Bdjob

Got a question?send us an email or call us at +880 1773-440094