**Health Insurance Claims Specialist**

1 day ago

Kanpur, Uttar Pradesh, India beBeeHealth Full time ₹ 9 - ₹ 12

**Job Overview**

We are seeking an experienced professional to oversee and manage the end-to-end claims process for our customers.

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 role based on-site with immediate joining.

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  • Claims Processing & Adjudication: 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 IRDAI 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.

**Key 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.
  • Proficiency in MS Office and claims management/CRM systems.

**Why Choose This Role?**

  • Be part of creating a vertical from scratch at a fast-growing fintech.
  • Opportunity to build something new and be at the forefront of innovation.
  • Professional growth and development opportunities.

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