Claims & Customer Service Representative (Health Insurance)

About the role

We are seeking a detail‑oriented Claims & Customer Service Representative to join our health‑insurance team in Tripoli. The role combines direct member support with accurate processing of insurance claims, ensuring compliance with policy terms.

Key responsibilities

• Respond to member inquiries via email or phone, providing timely and empathetic assistance.
• Verify member eligibility, premium status, and confirm claim eligibility.
• Update claim records, reimbursement notices, and member information in the system.
• Forward validated claims for payment processing and ensure alignment with provider tariffs.
• Document services using appropriate medical codes and escalate complex cases to the medical team.
• Log and route service requests, follow up on unresolved issues, and support daily operational flow.

Required profile

• Diploma or Bachelor’s degree in a medical, pharmaceutical, or healthcare‑related field (preferred).
• Minimum 1 year of experience in customer care, claims handling, or healthcare administration.
• Excellent command of English and strong interpersonal skills.
• Ability to work in a fast‑paced, service‑focused environment.

Required skills

• High proficiency in Microsoft Excel.
• High proficiency in Microsoft Word.