
Claims Management Professional
20 hours ago
The role involves efficiently and accurately processing cashless insurance claims, ensuring timely closure to policyholders.
This includes verifying policy coverage, reviewing medical records, coordinating with insurance providers, and communicating updates on claim status to employees or dependants.
Key Responsibilities:
- Manage end-to-end cashless claims of employees, including verifying policy coverage, reviewing medical records, and coordinating with Insurers.
- Verify Policy Coverage: Review and verify policy details to ensure eligibility for cashless processing according to insurance policy terms and conditions.
- Provide Customer Service: Respond to inquiries from employees regarding claim status and related queries.
- Coordinate with Healthcare Providers/Hospitals: Communicate with healthcare providers to obtain additional information, clarify details, and resolve discrepancies.
- Maintain Records: Keep detailed and accurate records of all claim-related activities, communications, and transactions for documentation and audit purposes.
- Achieve High Customer Satisfaction: Ensure high customer satisfaction in cashless claims handled.
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