Health Insurance Claims Specialist
5 days ago
We are seeking a skilled and dedicated Claims Representative to join our team. This role involves processing and evaluating health insurance claims with accuracy and fairness.
Key Responsibilities:- Process and evaluate health insurance claims in a timely and efficient manner.
- Verify policy coverage, eligibility, and supporting documents to ensure compliance with company policies and regulations.
- Communicate clearly with customers and provide updates on claim status to maintain a positive customer experience.
- Ensure seamless settlement by coordinating with hospitals, TPAs, and policyholders as needed.
- Maintain accurate records and follow up on pending claims to ensure timely resolution.
- Proven experience in health insurance claims handling/management (TPA/insurer background preferred).
- Strong understanding of insurance processes & regulations.
- Excellent customer service & communication skills (written & verbal).
- Strong analytical, problem-solving & attention-to-detail abilities.
- Ability to work independently and as part of a team.
- Bachelor's degree (Commerce, Healthcare, Insurance, or related field preferred).
This is an excellent opportunity for a motivated and organized individual to develop their skills and contribute to the success of our organization.
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