Urgent Dedicated Claims Specialist

4 weeks ago


Pune, Maharashtra, India Loop Health Full time

We are looking for a Dedicated Claims Specialist with a strong background in medical and health insurance particularly in group medical corporate policies The ideal candidate should have 2-4 years of experience in claims processing or CRM roles Key Responsibilities Handle end-to-end processing of reimbursement claims for group medical corporate policies Provide excellent customer service by addressing claims-related queries via Freshchat Ozontel and Freshdesk Analyze medical documentation policy terms and conditions to ensure accurate claim assessment and processing Liaise with internal teams insurers TPA s and hospitals to ensure seamless claims settlement and timely resolutions Manage claims escalations ensuring prompt resolution while maintaining a customer-centric approach Required Skills In-depth knowledge of corporate group medical insurance policies and claims processing Ability to understand medical terminology treatment procedures and health-related documentation Proficient in Ozontel Freshdesk or similar customer support and claims management tools Strong communication and problem-solving skills to manage customer relationships and resolve issues effectively Attention to detail to ensure accuracy in claim processing and documentation review Ability to collaborate effectively with cross-functional teams including insurance partners and hospital networks Qualifications Bachelor s degree in healthcare insurance or related field preferred 2-4 years of experience in claims processing CRM role preferably within group medical corporate policies



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