
Insurance Claim Resolution Specialist
10 hours ago
The ideal candidate will be responsible for evaluating insurance claims, investigating their legitimacy, and facilitating timely and fair settlements.
Key Responsibilities:
- Claim Processing: Manage the entire claims process, from reviewing submitted documentation to determining eligibility based on policy coverage.
- Data Analysis: Analyze data in accordance with provided SOPs (Standard Operating Procedures) to ensure accurate and efficient claim handling.
- Claim Validation & Investigation: Conduct thorough investigations by collecting relevant data, conducting interviews, and working with adjusters and external experts to verify claim validity.
- Client Communication: Keep policyholders and agents informed on the status of claims, provide clarity on coverage decisions, and guide them through the settlement process.
- Settlement Negotiation: Negotiate settlement amounts with claimants and third parties, ensuring that settlements are fair, within policy limits, and compliant with legal standards.
- Documentation & Reporting: Maintain detailed records of claims processing activities, including assessments, investigation reports, and settlement documentation.
- Fraud Detection: Identify and flag potential fraudulent claims, collaborating with the fraud investigation team when necessary.
- Compliance: Ensure all claims are processed in adherence to industry regulations and legal requirements.
- Collaboration with Legal Team: Work with the legal team on disputed claims or cases involving litigation to ensure proper handling.
- Customer Service: Deliver exceptional customer service by addressing claim-related inquiries, resolving disputes, and ensuring a smooth claims experience for policyholders.
- Continuous Improvement: Recommend improvements to enhance efficiency and reduce claims processing time.
-
Medical Claims Resolution Specialist
2 weeks ago
Rajkot, Gujarat, India beBeeClaims Full time ₹ 6,00,000 - ₹ 8,00,000As a Medical Claims Resolution Specialist, you will play a vital role in ensuring accurate reimbursement for healthcare providers. Your responsibilities will include contacting insurance companies to follow up on outstanding medical claims and navigating complex billing and coding rules.Key Responsibilities:Follow-up and Resolution:You will initiate calls to...
-
Insurance Claims Specialist
1 week ago
Rajkot, Gujarat, India beBeeClaims Full time ₹ 50,00,000 - ₹ 70,00,000Health Insurance Claims ProfessionalWe seek an individual to process and evaluate health insurance claims with accuracy and fairness.Key Responsibilities:Verify policy coverage, eligibility, and supporting documents.Coordinate hospital visits, Third-Party Administrator (TPA) interactions, and customer communication for seamless claim resolution.Ensure timely...
-
AR Medical Claims Resolutions Specialist
4 days ago
Rajkot, Gujarat, India beBeeCommunication Full time ₹ 30,00,000 - ₹ 60,00,000As an AR calling specialist, you play a vital role in communicating with insurance companies and patients to resolve outstanding medical claims.Key Responsibilities:Initiate follow-up calls to inquire about denied claims statuses.Maintain thorough records of all interactions and follow-up actions.Re-submit claims with corrected information or appeal...
-
Dental Claims Specialist
3 days ago
Rajkot, Gujarat, India beBeeClaims Full time ₹ 50,00,000 - ₹ 80,00,000Job OverviewWe are seeking a skilled Billing & Claims Specialist to join our team. This role involves preparing and submitting dental insurance claims accurately and on time.The ideal candidate is detail-oriented, organized, and familiar with dental billing processes. Key responsibilities include:Preparing and submitting dental insurance claims for...
-
Rajkot, Gujarat, India beBeeClaim Full time ₹ 15,00,000 - ₹ 20,00,000Health Insurance Claims ManagerWe're seeking a skilled Health Insurance Claims Manager to oversee and manage the end-to-end claims process for customers. In this role, you will serve as the primary liaison between clients, insurers, third-party administrators (TPAs), and healthcare providers to ensure claims are handled smoothly, accurately, and on time.Key...
-
Marine Insurance and Claims Manager
3 days ago
Rajkot, Gujarat, India beBeeInsurance Full time ₹ 1,00,00,000 - ₹ 1,50,00,000This role will be responsible for the overall management of marine insurance and claims within the organization. The successful candidate will serve as the leader of the MI&C department, acting as the primary point of contact for all marine insurance and claims related matters.Key ResponsibilitiesLeadership and Management: Oversee the MI&C team, ensuring...
-
AR Claims Recovery Specialist
2 days ago
Rajkot, Gujarat, India beBeeDenial Full time ₹ 36,60,000 - ₹ 61,10,000Job Summary:A Medical Claims Resolution Specialist is responsible for contacting insurance companies and patients to follow up on outstanding medical claims, ensuring accurate reimbursement by navigating complex billing and coding rules.Key Responsibilities:Follow-up and Resolution: Initiate calls to insurance companies to inquire about denied claims...
-
Senior Cashless Insurance Claims Coordinator
2 days ago
Rajkot, Gujarat, India beBeeClaims Full time ₹ 60,00,000 - ₹ 1,20,00,000About the JobA Claims Management Specialist plays a pivotal role in ensuring timely and accurate processing of cashless insurance claims for policyholders.This position involves efficiently managing end-to-end cashless claims, verifying policy coverage, reviewing medical records, coordinating with insurers, and ensuring seamless communication with employees...
-
Insurance Financial Process Specialist
1 week ago
Rajkot, Gujarat, India beBeeFinance Full time ₹ 60,00,000 - ₹ 1,20,00,000Finance Specialist Job SummaryWe are seeking an experienced Finance Specialist to join our team. This role will involve working closely with the finance and actuarial teams to ensure the integrity of financial data and compliance with industry standards throughout a large-scale transformation program.This is a challenging opportunity for a skilled...
-
Senior Claims Specialist
2 days ago
Rajkot, Gujarat, India beBeeInsurance Full time ₹ 10,00,000 - ₹ 25,00,000Insurance Claims AnalystAbout Our Company:We are a leading Business Process Management (BPM) company that combines deep industry knowledge with technology and analytics expertise to co-create innovative, digital-led transformational solutions with clients across various industries.Our services include finance and accounting, procurement, customer interaction...