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1 day ago
We are seeking a skilled Cashless Claims Professional to join our team. In this role, you will be responsible for managing cashless insurance claims efficiently and accurately.
Key Responsibilities:- Act as a claims expert - Manage end-to-end cashless claims of employees, verifying policy coverage, reviewing medical records, coordinating with Insurers, and ensuring that claims are processed accurately and efficiently.
- 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 that may arise during the processing of cashless claims.
- 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.
Internal Clients:
- Endorsement team
- Onboarding team
- Products & engineering
- Claims teams
- Support Inbound
- Account Management
External Clients:
- Insurers
- Client HR's
- Hospitals
To succeed in this role, you should have at least 2 years of experience in customer-facing roles. Past experience in voice profile would be an added advantage. Experience in cashless/TPA is also beneficial.
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