Senior Health Insurance Professional

6 days ago

Mumbai, Maharashtra, India beBeeClaims Full time ₹ 15,00,000 - ₹ 20,00,000

About our company, GrayQuest is a FinTech leader in the education space.

Transforming the $100B+ education industry through innovative financial solutions, we make education more accessible and affordable for millions of Indian families.

We partner with 5,000+ top educational institutions nationwide to provide reliable and trustworthy financial services. Backed by respected investors and entrepreneurs, we're poised to expand into new markets.

Our goal is to revolutionize the insurance vertical by offering customized life and health insurance products to families within our network and beyond.

Role Overview

We are seeking an experienced Health Insurance Claims Manager to oversee and manage the end-to-end claims process for customers. In this role, you will act 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 experience. This is a full-time role based in Mumbai with immediate joining.

Key Responsibilities

  • 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 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 enhancements to improve speed, accuracy, and customer satisfaction.

Requirements

Education

  • Bachelor's degree in Business, Finance, or related field.

Experience

  • 3–6 years of proven experience in health insurance claims management or related roles.

Certifications

  • 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.
  • Proficiency in MS Office and claims management systems.

Attributes

  • Customer-first mindset with empathy and professionalism.
  • Ability to work under pressure and meet deadlines.
  • Strong organizational skills and accountability.

Why Join Us?

Here's why we stand out:

  • Advice First, Always: We provide guidance, not pressure—helping families make informed decisions.
  • Build Something New: Be part of creating a vertical from scratch at a fast-growing fintech company.
  • Trust & Transparency: Regulatory compliance, customer-first service, and honesty are non-negotiable.

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