Claims Specialist

2 weeks ago

Bengaluru, Karnataka, India beBeeClaimsSpecialist Full time ₹ 15,00,000 - ₹ 20,00,000
Claims Specialist

We are seeking a highly skilled Claims Specialist to join our team.

The purpose of this role is to effectively manage the claims process for clients, ensuring a smooth and fair settlement of claims.

The ideal candidate will have prior experience in claims processing, claims handling, or related roles within the insurance industry.

Key Responsibilities:
  • Claims Processing and Documentation:
  • Accurately review and process claims in adherence to established protocols and guidelines.
  • Ensure all necessary documentation is collected and maintained for each claim, including client statements, accident reports, and relevant records.
  • Client Advocacy and Communication:
  • Act as the main point of contact for clients during the claims process, providing timely updates and information.
  • Advocate for clients' interests and rights, ensuring a fair and just settlement of claims.
  • Settlement or Compromised Settlement:
  • Engage in substantiating the claim to the insurers to secure optimal claim settlements for clients.
  • Ensure that settlements are fair and appropriate, considering policy terms, legal requirements, and clients' expectations.
  • Conflict Resolution and Customer Service:
  • Address client concerns, disputes, and inquiries related to claims in a professional and timely manner.
  • Facilitate conflict resolution and maintain positive client relationships throughout the claims process.
Requirements:
  1. Insurance Knowledge:
  • Possesses a strong understanding of insurance policies, coverages, and claims processing.
  • Familiarity with insurance regulations, industry standards, and claims-related legal aspects.
  1. Communication and Interpersonal Skills:
  • Demonstrates clear and effective communication, both written and verbal, to convey complex information to clients and internal stakeholders.
  • Exhibits strong interpersonal skills to manage client interactions with empathy and professionalism.
  1. Analytical Thinking and Problem-Solving:
  • Utilizes analytical skills to assess claim details, policy information, and relevant documents to make informed decisions.
  • Identifies potential challenges and develops effective solutions to ensure smooth claims processing.
  1. Negotiation and Persuasion:
  • Demonstrates effective negotiation skills to achieve optimal claim settlements for clients.
  • Persuasively presents clients' cases and arguments to insurers, supporting claims in the best interest of clients.
  1. Interpersonal Skills:
  • Strong interpersonal skills, including the ability to empathize with clients, manage client expectations, and effectively communicate during the claims process.
Preferred Qualifications:
  • A bachelor's degree in business, insurance, finance, or a related field.
  • Prior 10 years of work experience in claims processing, claims handling, or related roles within the insurance industry.
  • Relevant certifications in claims management or insurance claims.
  • Proficient in using claims management systems, CRM software, and Microsoft Office suite (Word, Excel, Outlook, etc.).
],

  • Cashless Claims Specialist

    3 days ago

    Bengaluru, Karnataka, India beBeeClaims Full time ₹ 5,67,890 - ₹ 12,34,567

    Cashless Claims Specialist RoleOur organization requires a skilled Cashless Claims Specialist to process and handle cashless medical claims, coordinate with hospitals and third-party administrators, verify patient information and insurance coverage, and ensure timely approval and settlement of claims.Main Responsibilities:Processing and handling cashless...

  • Health Insurance Claims Specialist

    2 days ago

    Bengaluru, Karnataka, India Novo Insure Full time

    Job Title: Health Claims Specialist Location: Bangalore - MG Road Salary: 4 Lacs to 6 Lacs Candidates Required: 1 Members Languages: English & Kannada About NOVO: NOVO Insurance Broking Pvt Ltd. is built by a passionate team of seasoned. Identified by IRDA as a trusted Insurance Broking Service, NOVO Insurance helps you diligently manage your finances, plan...

  • TPA Cashless Claims Specialist

    3 weeks ago

    Bengaluru, Karnataka, India Organo Mart Full time

    Job DescriptionRole DescriptionThis is a full-time on-site role for a TPA Cashless Claims Specialist - Domestic Health Insurance, based in Bengaluru. The role involves processing insurance claims, managing claims efficiently, communicating with customers and insurance companies, and ensuring excellent customer service throughout the claims...

  • Claims Processing Expert

    23 hours ago

    Bengaluru, Karnataka, India beBeeClaims Full time ₹ 4,00,000 - ₹ 6,00,000

    Insurance Claims SpecialistA highly skilled Insurance Claims Specialist is required to review, process and manage insurance claims in a timely, accurate and fair manner. This involves investigating claim details, verifying policy coverage, communicating with policyholders, providers or third parties and documenting all findings.About the Role:This position...

  • Claims Resolution Specialist

    2 weeks ago

    Bengaluru, Karnataka, India beBeeInsurance Full time ₹ 4,00,000 - ₹ 8,00,000

    Job Title: TPA Cashless Claims ExecutiveRole Overview:This is a full-time on-site opportunity for a TPA Cashless Claims Executive in Bengaluru.The selected individual will be responsible for managing and processing cashless claims, analyzing claims data, and ensuring timely and accurate resolution of claims.

  • Health Claims Examiner

    2 weeks ago

    Bengaluru, Karnataka, India beBeeMedicine Full time ₹ 15,00,000 - ₹ 20,00,000

    A Medical Claims Specialist plays a vital role in ensuring the accuracy and legitimacy of insurance claims. They review medical information and data, analyze reports and documents to assess claim validity and provide recommendations for processing. In this position, you will be responsible for analyzing medical records and reports to determine claim validity...

  • Healthcare Claims Specialist

    17 hours ago

    Bengaluru, Karnataka, India beBeeResponsibilities Full time US$ 8,00,000 - US$ 10,00,000

    Job Summary:We are seeking a skilled Claims Processor to join our healthcare team.About the Role:This position involves managing and processing healthcare claims in a timely and accurate manner. The ideal candidate will possess strong organizational skills, attention to detail, and the ability to work well under pressure.Key Responsibilities:

  • Claims Network Specialist

    23 hours ago

    Bengaluru, Karnataka, India beBeeNegotiator Full time ₹ 8,00,000 - ₹ 12,00,000

    Job Title: Motor Claims ManagerAs a key member of our motor insurance team, you will play a critical role in managing and building our motor garage and surveyor network.Lead the coordination between customers, surveyors, and garages to deliver a seamless and rapid claims process.Monitor key metrics (TAT, quality, cost) and drive service excellence.Key...

  • Operations Management Specialist

    2 days ago

    Bengaluru, Karnataka, India beBeeLeadership Full time

    About this role:We are seeking a highly skilled professional to lead our Fraud and Claims Operations team. In this critical position, you will supervise a team of specialists and oversee proactive fraud identification, prevention, and detection.Supervise a team of specialists within a fraud and claims program for proactive fraud identification, prevention,...

  • Billing Specialist

    3 weeks ago

    Bengaluru, Karnataka, India LifeLab Kids Full time

    Job DescriptionWe are looking for an experienced Billing Specialist to join our team.Responsibilities:Understands the entire billing lifecycle invoicing, claims submissions, post payments and collections using the Central Reach platform.- Provide administrative support to internal employees.- Identify billing inconsistencies and provide claims guidance-...