_{16th April, 2026}

JOB TITLE: Claims Adjudicator
LOCATION: Medellin, Colombia
TYPE: Full-time
SCHEDULE: Monday - Friday, 7:30 a.m. to 5:00 p.m. (COT) - Hybrid
TYPE OF CONTRACT: Permanent with benefits (Colombian Law)
PAY RATE: COP$4.000.000/Month


DESCRIPTION:
The Claims Analyst is responsible for evaluating and processing claims in accordance with policy benefits and contractual conditions for a leading organization in the insurance sector. This role ensures high-quality standards through the accurate adjudication of claims, maintaining meticulous attention to detail and strict adherence to policy guidelines. The successful candidate will act as a key link in the claims lifecycle, ensuring precision in financial distributions and compliance with medical and legal frameworks.


Key Responsibilities:

• Review and adjudicate claims based on specific policy benefits and contractual terms.
• Refer claims to the medical department for coverage analysis in specialized or complex cases.
• Generate and manage detailed claims reports to ensure operational transparency.
• Perform CTP coding and ICD-10 coding to ensure accurate and standardized processing.
• Validate banking information to ensure correct and timely payment distribution.
• Associate medications with presented diagnoses to verify coverage eligibility.
• Validate expenses in relation to coverage renewal dates and specific policy timelines.
• Calculate expenses and deductibles per policy year with high precision.
• Validate waiting periods and verify pre-existing conditions, exclusions, and deductible increases.
• Validate service dates and perform necessary currency conversions for international or multi-currency claims.
• Apply general policy benefits according to the specific plan contracted by the user.

REQUIREMENTS

• Education: Student or professional degree in Business Administration, Finance, or related fields.
• Experience: Minimum of two years of experience in claims processing or a related role within the insurance sector.
• Customer Service: Demonstrated experience providing high-quality customer service and conflict resolution.
• Technical: Proficiency in relevant computer tools, insurance software, and Microsoft Office Suite.
• Communication: Professional English is a Must. Excellent oral and written communication skills with a focus on professional clarity.
• Skills: Ability to work effectively under pressure, dynamic personality, and strong interpersonal skills.
• Execution: Proven ability to follow complex oral and written instructions with meticulous accuracy.

ttg Talent Solutions is an Equal Opportunity Employer and recruiting agency. We are committed to creating an inclusive and diverse work environment and welcome applications from all qualified candidates regardless of race, color, religion, gender, sexual orientation, national origin, age, disability, or veteran status. Please note that all offers of employment are contingent upon the successful completion of a drug test and background check. We maintain a drug- and substance-free workplace to ensure the safety and well-being of all employees.

At ttg, "We believe in making a difference One Person at a Time," ttg OPT.
 
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