
Insurance Claims Process Lead
1 week ago
We are seeking an experienced professional to oversee and manage the end-to-end claims process for our customers.
This is a high-impact opportunity to be at the forefront of building a new vertical from the ground up, ensuring smooth, accurate, and timely claim resolutions.
The successful candidate will serve as the primary liaison between clients, insurers, third-party administrators (TPAs), and healthcare providers, fostering strong relationships and driving business growth.
- Main Responsibilities:
- 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, 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.
- Proven experience in managing health insurance claims, preferably in a similar role.
- Strong knowledge of insurance regulations and compliance standards.
- Excellent communication and interpersonal skills, with the ability to build strong relationships with clients, insurers, and other stakeholders.
- Ability to work under pressure and meet deadlines, while maintaining a high level of accuracy and attention to detail.
- Bachelor's degree in a relevant field, such as Business Administration or Finance.
Our organization offers a dynamic and supportive work environment, with opportunities for career growth and development. We also provide a competitive salary package, comprehensive benefits, and a range of perks and incentives.
If you are a motivated and results-driven individual, looking for a challenging and rewarding role, please submit your application today
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