
Health Insurance Claims Executive
1 day ago
About Us
We transform the education industry through our innovative financial solutions.
Our flagship offering makes education more accessible, affordable, and rewarding for millions of families.
We partner with top educational institutions across the country, making us a trusted name in education-focused financial services.
Job RoleWe are seeking an experienced Health Insurance Claims Manager to oversee and manage the end-to-end claims process for our customers.
In this role, you will serve as the primary liaison between clients, insurers, TPAs, and healthcare providers to ensure claims are handled smoothly, accurately, and on time.
- Manage the 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 (TPAs), 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 guidelines 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 process enhancements to improve speed, accuracy, and customer satisfaction.
A bachelor's degree in Business, Finance, Insurance, or related field is required.
A minimum of 3–6 years of proven experience in health insurance claims management or related roles is necessary.
Certification in health insurance is preferred.
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