Insurance Claim Specialist

2 months ago


Pune, India Hiretalents Full time
The person in this role will act as an ambassador for our client when interacting with customers (Patients) hospital staff and Insurance claims team at various insurance companies and thirdparty administrators. They will support our daytoday operations at the hospital level with the support of the central operations team of our client and help us continually improve the internal processes of our growing organization. Claims Specialist at our client has an important role in providing complete insurance solutions with great growth prospects.
Responsibilities and Duties.
  • Serve as a point of contact for Insurance related inquiries
  • Create a consistent positive work atmosphere through the communication
  • Close interaction with respective department at hospital
  • To interact with hospital insurance patients.
  • Interact with Hospital Management Doctors Medical and nonmedical staff at the hospital
  • To create awareness about insurance claims (reimbursement and cashless claims pre & post hospitalization claims etc.)
  • Collecting claim support documents from the patients / hospitals & coordinate with backend team to ensure smooth transfer of data to the TPA/Insurance Company.
  • Send the pre auth request and follow up on cashless approval form insurance company.
  • Efficiently and effectively handle grievance / issue raised by hospital staff & patients escalate issue to the team leader as when necessary.
  • Followup and Updates to be given to the clients

Required Skills and Experience
  • Bachelor s Degree or Diploma (or equivalent experience)
  • Excellent written & spoken English and business communication skills
  • Should have good analytical skills that helps Planning forecasting &
  • Should be confident with the ability to build and maintain constant rapport with the business and be handson where required
  • Positive attitude with strong communication skills and approachable demeanor when working with all levels of staff
  • Ability to work independently quickly learn organizational structure and demonstrate excellent time management skills

insurance claims,management,communication skills,insurance,operations,analytical skills,communication,claims handling,claims management,claims review,accident claims,casualty claims,claim investigation,claims resolution,delay claims,employment claims



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