
Claims Resolution Specialist
15 hours ago
Health Insurance Claims Specialist Job Description
About the RoleWe are seeking a skilled Health Insurance Claims Specialist to join our team. As a key member of our operations, you will be responsible for handling claims with accuracy, empathy, and efficiency.
Key Responsibilities:- Process and evaluate health insurance claims with fairness and attention to detail
- Verify policy coverage, eligibility, and supporting documents to ensure smooth claim experiences
- Coordinate with hospitals, third-party administrators (TPAs), and policyholders for seamless settlement
- Maintain accurate records and follow up on pending claims to ensure timely resolution
- Communicate clearly with customers and provide updates on claim status
- Ensure compliance with regulatory requirements
- Experience in health insurance claims handling or management, preferably with a TPA or insurer background
- Strong understanding of insurance processes and regulations
- Excellent customer service and communication skills, both written and verbal
- Strong analytical, problem-solving, and attention-to-detail abilities
- Ability to work independently and as part of a team
- Bachelor's degree in Commerce, Healthcare, Insurance, or a related field
In this role, you will have the opportunity to make a real difference in customers' lives. Our collaborative work culture provides growth opportunities, a competitive salary and benefits package, and a chance to be part of a dynamic team.
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