Claims Manager

• main benefits

  
  
  • Base Salary: €970.00;
  
  
  • Meal Allowance: €10.46 / working day;
  
  
  • Work Model: Hybrid (Remote and On-site);
  
  
  • Working Hours: 09:00 - 18:00;
  
  
  • Days Off: Saturday and Sunday (fixed days off);
  
  
  • Excellent facilities, a work environment with natural light and a fully equipped break room with a dining area.
  
  
  
  
  

  Randstad's mission is to become the most equitable and specialized talent company in the world, and therefore we reiterate that we welcome people with the most diverse abilities and experiences. We are committed to ensuring that our recruitment and hiring process meets the needs of all people. If you need any accommodation to make your application or interview more comfortable, please do not hesitate to inform our recruitment consultants.

Are you looking for a job with regular hours and weekends off? Would you like to work in the insurance sector within the healthcare area?

Our client is a prestigious company providing clinical services and health prevention management, which manages Insurance and Health Plans for various Insurers, Subsystems, and Partners, and is looking for a Claims Manager to join their team!

• key responsibilities

  
  
  • Analyze and interpret the information contained in the documents associated with the claim, the most relevant of which is the claim typology (medical, hospital, other), identification of the Insured Person, medical act performed, amount invoiced, and documentation presented;
  
  
  • Enter information relating to the claim into the IT system, maintaining the process history;
  
  
  • Validate system alerts (reviews) and corresponding processing, streamlining interaction for approvals from another hierarchical level if necessary;
  
  
  • Assess the feasibility of payment or the need for return/refusal, ensuring the execution of all established procedures for different situations until the closing of the claim process;
  
  
  • Proceed with the follow-up of pending claims, controlling the pending portfolio and activating mechanisms for their respective resolution (intra- and interdepartmental interactions).