Insurance Claims Manager

4 days ago

Bengaluru, Karnataka, India beBeeClaimsManager Full time ₹ 75,00,000 - ₹ 95,00,000

About the Position:

The primary objective of this role is to manage and process cashless insurance claims with utmost efficiency and accuracy, thereby ensuring timely closure to policyholders and seamless coordination with insurance providers.

Key responsibilities include verifying policy coverage, reviewing medical records, coordinating with Insurers, and ensuring that claims are processed accurately and efficiently. The role also involves communicating with employees or dependants to provide updates on the status of their claims and address any questions or concerns.

Main Responsibilities:

  • Process end-to-end cashless claims of employees, verifying policy coverage, reviewing medical records, and coordinating with Insurers.
  • Verify Policy Coverage: Review and verify policy details to ensure claim eligibility for cashless processing according to insurance policy terms and conditions.
  • Provide Customer Service: Respond to inquiries from employees and other stakeholders regarding claim status and related queries.
  • Coordinate with Healthcare Providers/Hospitals: Obtain additional information and clarify details as needed.
  • Resolve Issues: Investigate and resolve discrepancies, errors, or issues arising during claim processing to ensure timely and accurate resolution.
  • Maintain Records: Keep detailed and accurate records of all claim-related activities, communications, and transactions for documentation and audit purposes.
  • Meet or exceed established service level agreements and performance metrics related to claim processing, turnaround time, accuracy, and customer satisfaction.

Interactions:

-Internal Clients: Endorsement team, Onboarding team, Products & engineering, Claims teams, Support Inbound, Account Management

-External Clients: Insurers, Client HR's, Hospitals

Requirements:

  • At least 2 years of experience in customer-facing roles
  • Past Experience in voice profile would be an added advantage
  • Experience in cashless/ TPA

About You:

We are looking for a skilled professional who can effectively manage and process cashless insurance claims, possess excellent communication skills, and have prior experience in customer-facing roles. If you have the required skills and qualifications, please submit your application for this exciting opportunity.

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