Health Insurance Claims Specialist

3 days ago

Bhavnagar, Gujarat, India beBeeClaims Full time ₹ 12,00,000 - ₹ 20,00,000

About this role

We are seeking an experienced Health Insurance Claims Manager to oversee and manage the end-to-end claims process for our customers. In this role, you will serve as the primary liaison between clients, insurers, 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 with immediate joining based in Bhavnagar.

Job Description:

We require a highly organized and detail-oriented individual to handle the complete lifecycle of health insurance claims. This includes verification, documentation, submission, follow-up, and settlement.

  • Manage the end-to-end claims process, ensuring timely and accurate handling.
  • Collaborate with various stakeholders to resolve claims efficiently.
  • Handle escalations, rejections, and disputes by investigating discrepancies and negotiating fair outcomes.
  • Ensure compliance with IRDAI guidelines, insurer protocols, and internal standards.

Requirements:

We require a Bachelor’s degree in Business, Finance, Insurance, or related field. The ideal candidate should have 3-6 years of proven experience in health insurance claims management or related roles.

Preferrably, you hold IRDAI Health Insurance certification or equivalent.

You should possess a strong knowledge of health insurance policies, products, and claims procedures. Excellent communication, negotiation, and customer-handling skills are essential.

High attention to detail with strong analytical and problem-solving abilities is required.

Proficiency in MS Office and claims management/CRM systems is necessary.

Key Responsibilities:

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