**Claims Adjudicator** **Medellín** **Permanent Position** **Monday to Friday, 7:30 AM - 5:00 PM - Colombian Calendar / Hybrid** **Description**: The Claims Adjudicator is responsible for evaluating and processing claims in accordance with policy benefits and contractual conditions. Maintaining high-quality standards by ensuring accurate claims adjudication. **RESPONSIBILITIES AND FUNCTIONS**: **Essential Functions**: - Review and adjudicate claims based on policy benefits. - Submit claims for coverage analysis to the medical department in specific cases. - Generate reports. - CTP coding. - ICD-10 coding. - Validate banking information. - Associate medications with the presented diagnosis. - Validate expenses with coverage renewal dates. - Calculate expenses and deductibles per policy year. - Validate waiting periods. - Validate pre-existing conditions, exclusions, and deductible increases. - Validate service dates. - Perform currency conversions. **Requirements (Knowledge and Skills)**: - Student or holder of a degree in Business Administration or related fields. - Minimum of two years of experience in the field. - Experience in high-quality customer service. - Competence in relevant software utilities. - Effective communication, both oral and written. - Ability to work under pressure. - Dynamic and energetic. - Strong interpersonal skills. - Ability to follow oral and written instructions. - 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