Claims Professional
1 week ago
Job Summary:
We are seeking a skilled Claims Professional to join our team. As a Claims Specialist, you will play a crucial part in processing and managing cashless insurance claims efficiently and accurately.
Key Responsibilities:
- Managing end-to-end cashless claims of employees, including verifying policy coverage, reviewing medical records, and coordinating with Insurers.
- Verifying policy details to ensure that the claim is eligible for cashless processing according to the terms and conditions of the insurance policy.
- Providing customer service by responding to inquiries from employees and other stakeholders regarding claim status and related queries.
- Coordinating with healthcare providers to obtain additional information, clarify details, and resolve issues that may arise during the processing of cashless claims.
- Maintaining detailed and accurate records of all claim-related activities, communications, and transactions for documentation and audit purposes.
- Meeting or exceeding established service level agreements and performance metrics related to claim processing, turnaround time, accuracy, and customer satisfaction.
Requirements:
This role requires at least 2 years of experience in customer-facing roles, with past experience in voice profiles being an added advantage. Experience in cashless/TPA is also beneficial.
Benefits:
- Opportunity to work with a dynamic team
- Competitive salary and benefits package
- Professional growth and development opportunities
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