Health Insurance Claims Specialist

3 days ago


Kozhikode, Kerala, India beBeeClaims Full time ₹ 15,00,000 - ₹ 18,00,000

We're seeking a seasoned Claims Professional to lead the end-to-end claims process for our customers.

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.

Key Responsibilities:

  • Manage the complete lifecycle of health insurance claims, including verification, documentation, submission, follow-up, and settlement.
  • Assist and guide customers through the claims journey, ensuring forms and documents are accurate, complete, and submitted promptly.
  • Collaborate with insurers, third-party administrators (TPAs), and hospitals to ensure quick and accurate claim resolutions.
  • Handle escalations, rejections, and disputes by investigating discrepancies, clarifying benefits, and negotiating fair outcomes for clients.
  • Ensure claims handling aligns with regulatory guidelines, insurer protocols, and internal compliance standards.
  • Track claim turnaround times, analyze claim outcomes, and prepare periodic reports on performance and trends.
  • Identify inefficiencies in claims workflows and recommend process enhancements to improve speed, accuracy, and customer satisfaction.

Requirements:

Education:

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

Experience:

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

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/CRM systems.

Attributes:

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

Why This Role?

This is an exciting opportunity to be part of building a new vertical from scratch at a fast-growing fintech company.

We offer a dynamic work environment, opportunities for growth and development, and a chance to make a real impact in the lives of our customers.



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