Insurance Claim Expert

1 day ago


Pune, Maharashtra, India beBeeClaims Full time ₹ 8,00,000 - ₹ 12,00,000

Job Title: Dedicated Claims Specialist

 

We are seeking a highly skilled Dedicated Claims Specialist to join our team. As a key member of our insurance organization, you will play a vital role in handling end-to-end processing of reimbursement claims for group medical corporate policies.

 

Key Responsibilities:

    Handle all aspects of claim processing, from initial submission to final settlement.

    Provide exceptional customer service by addressing claims-related queries via various communication channels.

    Analyze medical documentation, policy terms and conditions to ensure accurate claim assessment and processing.

    Collaborate with internal teams, insurers, TPAs, and hospitals to ensure seamless claims settlement and timely resolutions.

    Manage claims escalations, ensuring prompt resolution while maintaining a customer-centric approach.

 

Required Skills:

    In-depth knowledge of corporate group medical insurance policies and claims processing.

    Ability to understand medical terminology, treatment procedures, and health-related documentation.

    Proficient in Ozontel, Freshdesk, or similar customer support and claims management tools.

    Strong communication and problem-solving skills to manage customer relationships and resolve issues effectively.

    Attention to detail to ensure accuracy in claim processing and documentation review.

    Ability to collaborate effectively with cross-functional teams, including insurance partners and hospital networks.

 

Qualifications:

    Bachelor's degree in healthcare, insurance, or related field preferred.

    2-4 years of experience in claims processing or CRM role preferably within group medical corporate policies.



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