Health Insurance Claim Specialist

3 days ago

Ellore, Andhra Pradesh, India beBeeClaims Full time ₹ 80,00,000 - ₹ 1,50,00,000
Job Overview

We seek an experienced Health Insurance Claims Manager to oversee and manage the end-to-end claims process for our customers. As primary liaison between clients, insurers, TPAs, and healthcare providers, you will ensure claims are handled smoothly, accurately, and on time.

The ideal candidate has a strong background in health insurance claims management, excellent problem-solving skills, and customer-centric experience. This is a full-time role based in Mumbai with immediate joining.

Key Responsibilities:
  • Manage 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, 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 requirements 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 enhancements to improve speed, accuracy, and customer satisfaction.
Requirements
  • Bachelor's degree in Business, Finance, Insurance, or related field.
  • 3–6 years of proven experience in health insurance claims management or related roles.
  • Strong knowledge of health insurance policies, products, and claims procedures.
  • Excellent communication, negotiation, and customer-handling skills.
  • High attention to detail with analytical and problem-solving abilities.
  • Proficiency in MS Office and claims management/CRM systems.
  • Customer-first mindset with empathy and professionalism.
  • Ability to work under pressure and meet deadlines.
  • Strong organizational skills and accountability.

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