Insurance operation Executive

3 weeks ago


Mumbai, India Talent Corner HR Services Pvt Ltd Full time

Key Responsibilities:

  • Process reimbursement claims and verify policyholder eligibility.
  • Address queries related to claims, policies, and other concerns promptly and accurately.
  • Resolve grievances and disputes in collaboration with the claims operations team to maintain high customer satisfaction levels.
  • Track claims files, maintain records, and prepare reports for management review.
  • Manage escalations related to claims processing and ensure timely resolution.
  • Collaborate with internal teams to streamline processes and enhance operational efficiency.
  • Stay updated with industry trends, regulations, and best practices in claims management.

Requirements:

  • Bachelor's degree in Business Administration, Healthcare Management, or a related field.
  • Minimum 1-2 years of relevant experience in TPA, Insurance, or healthcare service providers.
  • Proficiency in MS Office suite (Word, Excel, PowerPoint) and experience with claims management software preferred.
  • Excellent oral and written communication skills to effectively interact with policyholders, internal teams, and stakeholders.
  • Strong analytical and problem-solving abilities to assess claim validity and resolve issues efficiently.
  • Ability to work independently and collaboratively in a fast-paced environment while maintaining attention to detail.
  • Demonstrated ability to prioritize tasks, meet deadlines, and adapt to changing priorities.
  • Knowledge of insurance regulations and industry standards is a plus.


This job description outlines the primary responsibilities and requirements for the TPA Insurance Operation Executive role. Successful candidates will have the opportunity to contribute to the efficient functioning of the claims department and ensure high-quality service delivery to policyholders.


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