Senior Health Insurance Claims Specialist

15 hours ago

Vijayawada, Andhra Pradesh, India beBeeClaims Full time ₹ 20,00,000 - ₹ 25,00,000
Claims Manager Role Overview

Our organization is seeking an experienced 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.

  • Claims Processing & Adjudication: Manage the complete lifecycle of health insurance claims, including verification, documentation, submission, follow-up, and settlement.
  • Customer Coordination: Assist and guide customers through the claims journey, ensuring forms and documents are accurate, complete, and submitted promptly.
  • Insurance & TPA Liaison: Collaborate with insurers, third-party administrators (TPAs), and hospitals to ensure quick and accurate claim resolutions.
  • Issue Resolution: Handle escalations, rejections, and disputes by investigating discrepancies, clarifying benefits, and negotiating fair outcomes for clients.
  • Compliance & Accuracy: Ensure claims handling aligns with industry guidelines, insurer protocols, and internal compliance standards.
Requirements

Education

  • Bachelor's degree in Business, Finance, Insurance, or related field.

Experience

  • 3–6 years of proven experience in health insurance claims management or related roles.

Certifications

  • Industry certification or equivalent preferred.

Skills

  • Strong knowledge of health insurance policies, products, and claims procedures.
  • Excellent communication, negotiation, and customer-handling skills.
  • High attention to detail with strong analytical and problem-solving abilities.

Attributes

  • Customer-first mindset with empathy and professionalism.
  • Ability to work under pressure and meet strict deadlines.
Why This Role Matters

Here's why this opportunity stands out:

  • Advice First, Always: We provide guidance, not pressure—helping families make confident decisions.
  • Build Something New: Be part of creating a vertical from scratch at a fast-growing organization.
  • Trust & Transparency: Compliance, customer-first service, and honesty are non-negotiable.

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