
Healthcare Claim Resolution Professional
4 days ago
As a Claims Resolution Specialist, you will be responsible for ensuring timely and accurate processing of health insurance claims. This is an exciting opportunity to join our team and contribute to the success of our organization.
About the Role:We are seeking a detail-oriented individual with excellent analytical and problem-solving skills. The ideal candidate will have experience in health insurance claims handling/management and a strong understanding of insurance processes & regulations.
- Main Responsibilities:
- Process and evaluate health insurance claims with accuracy and fairness.
- Verify policy coverage, eligibility, and supporting documents.
- Coordinate with healthcare providers and policyholders for seamless settlement.
- Maintain records and follow up on pending claims to ensure timely resolution.
- Communicate clearly with customers and provide updates on claim status.
- Ensure compliance with regulatory requirements and internal policies.
- Bachelor's degree in Commerce, Healthcare, Insurance, or related field (preferred).
- Experience in health insurance claims handling/management (TPA/insurer background preferred).
- Strong analytical, problem-solving & attention-to-detail abilities.
- Excellent customer service & communication skills (written & verbal).
- Ability to work independently and as part of a team.
We offer a collaborative work culture with opportunities for growth, a competitive compensation package, and the chance to make a real difference in people's lives.
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