Claim Service Officer

The Claims/ Client Service Oficer plays a crucial role in the eficient management of claims and ensures that customers receive assistance and support throughout their experience with EFU Life Assurance Ltd. 

• Visit designated network hospitals and other assigned facilities to assess patient admissions and gather necessary information on insured individuals.
• Verify the identity of the insured using CNIC and ensure compliance with internal policies and regulations.
• Monitor and document any challenges or issues faced by customers in hospitals, reporting them to the head ofice for timely resolution.
• Review patient fles, examine medical notes, and assess the medical necessity of admissions and investigations performed, discussing fndings with the supervisor.
• Identify and report unjustifed or unnecessary admissions to the supervisor for further evaluation.
• Maintain oversight on billing issues on a daily basis, communicating any discrepancies or concerns regarding bill amounts to the supervisor.
• Verify claims for non-network hospitals within the city and surrounding areas, ensuring prompt and accurate processing.
• Provide exceptional customer service by addressing inquiries and concerns from clients regarding their claims status and related processes.