Health Insurance Claims Specialist

17 hours ago

Bharatpur, Rajasthan, India beBeeClaimsHandler Full time ₹ 15,00,000 - ₹ 30,00,000
Claims Handler Opportunity

We are seeking a skilled Claims Handler to oversee and manage the entire claims process for our customers. In this role, you will serve as the primary liaison between clients, insurers, third-party administrators (TPAs), and healthcare providers to ensure claims are handled smoothly, accurately, and on time.

The ideal candidate will have a strong background in health insurance claims management, excellent problem-solving skills, and the ability to deliver a seamless, customer-focused experience. This is a full-time, on-site role based in Mumbai with immediate joining.

Key Responsibilities:

  • Claims Lifecycle Management: Manage the complete lifecycle of health insurance claims, including verification, documentation, submission, follow-up, and settlement.
  • Customer Coordination: Assist and guide customers through the claims journey, ensuring forms and documents are accurate, complete, and submitted promptly.
  • Insurance & TPA Liaison: Collaborate with insurers, third-party administrators (TPAs), and hospitals to ensure quick and accurate claim resolutions.
  • Issue Resolution: Handle escalations, rejections, and disputes by investigating discrepancies, clarifying benefits, and negotiating fair outcomes for clients.
  • Compliance & Accuracy: Ensure claims handling aligns with regulatory guidelines, insurer protocols, and internal compliance standards.
  • Monitoring & Reporting: Track claim turnaround times, analyze claim outcomes, and prepare periodic reports on performance and trends.
  • Process Improvement: Identify inefficiencies in claims workflows and recommend process enhancements to improve speed, accuracy, and customer satisfaction.

Requirements:

  • Education: Bachelor's degree in Business, Finance, Insurance, or related field.
  • Experience: 3–6 years of proven experience in health insurance claims management or related roles.
  • Certifications: IRDAI Health Insurance certification or equivalent preferred.
  • Skills: Strong knowledge of health insurance policies, products, and claims procedures. Excellent communication, negotiation, and customer-handling skills. High attention to detail with strong analytical and problem-solving abilities.
  • Attributes: Customer-first mindset with empathy and professionalism. Ability to work under pressure and meet strict deadlines. Strong organizational skills and accountability.

Why Choose Us?

  • Customer-Centric Approach: We provide guidance, not pressure—helping families make confident decisions.
  • Innovative Culture: Be part of creating a new vertical from scratch at a fast-growing fintech.
  • Transparency & Trust: Compliance, customer-first service, and honesty are non-negotiable.

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