Claims Management Expert

3 days ago


Erode, Tamil Nadu, India beBeeClaims Full time ₹ 8,00,000 - ₹ 12,00,000

About this role:

We are seeking a Claims Specialist to efficiently process cashless insurance claims and ensure timely closure for policyholders. Their primary goal is to facilitate seamless coordination with insurance providers.

The job purpose of a Claims Specialist is to manage cashless claims for employees, verifying policy coverage, reviewing medical records, and coordinating with Insurers to ensure accurate and efficient processing.

They will also communicate with employees or dependants to provide updates on the status of their claims and address any questions or concerns.

This role facilitates the smooth and timely processing of cashless claims, ensuring employees receive the benefits they are entitled to.

Main Responsibilities:
  • 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 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.

Our ideal candidate should possess excellent communication skills, attention to detail, and experience in customer-facing roles. They must also be able to work effectively in a team environment and meet established service level agreements and performance metrics related to claim processing, turnaround time, accuracy, and customer satisfaction.



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