Senior Medical Claims Specialist

4 days ago

Noida, Uttar Pradesh, India beBeeCustomer Full time
Medical Claims Representative Job Description

At our organization, we are seeking a highly motivated and experienced individual to join our team as a Medical Claims Call Center Representative.

This is a frontline role where you will handle inbound calls related to medical claims and rejections. Your primary focus will be to provide exceptional customer service while resolving inquiries and concerns effectively, ensuring a positive experience for every member.

  • Answer incoming customer calls promptly and professionally.
  • Assist customers with navigating medical claims, including inquiries about submissions, rejections, and procedures.
  • Provide accurate and detailed information about claim processes, documentation requirements, and insurance coverage.
  • Investigate and resolve customer concerns with a focus on high satisfaction and clear communication.
  • Collaborate with internal departments like claims processing to address complex issues and expedite resolutions.
  • Maintain extensive knowledge of Niva Bupa products, medical billing codes, and claim procedures.
  • Document customer interactions and update records accurately in our system.
  • Identify and escalate critical or unresolved issues to the appropriate supervisor.

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