
Cashless Claims Specialist
15 hours ago
About this role:
We are seeking a skilled Cashless Claims Expert to join our team. This is a critical position that requires a high level of attention to detail and excellent communication skills.
This expert will be responsible for processing and managing cashless insurance claims efficiently and accurately, ensuring timely closure to policyholders and seamless coordination with insurance providers.
The ideal candidate will have strong analytical and problem-solving skills, as well as the ability to work effectively in a fast-paced environment.
The Cashless Claims Expert will be responsible for verifying policy coverage, reviewing medical records, coordinating with Insurers, and ensuring that claims are processed accurately and efficiently.
This role also involves providing customer service, responding to inquiries from employees, and other stakeholders regarding claim status, and any other related queries.
Key Responsibilities:
- Act as a Claims buddy - Manage end-to-end cashless claims of employees.
- Verify Policy Coverage: Review and verify policy details to ensure that the claim is eligible for cashless processing according to the terms and conditions of the insurance policy.
- Provide Customer Service: Respond to inquiries from employees, and other stakeholders regarding claim status, and any other related queries.
- Coordinate with Healthcare Providers/Hospitals: Communicate with healthcare providers to obtain additional information, clarify details, and resolve issues.
- Maintain Records: Keep detailed and accurate records of all claim-related activities, communications, and transactions for documentation and audit purposes.
- Adhere to Service Level Agreements: 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
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