Financial Health Insurance Specialist

1 week ago

Kolkata, West Bengal, India beBeeClaims Full time ₹ 80,00,000 - ₹ 1,50,00,000

Health Insurance Claims Manager

We are seeking an experienced professional 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.

Key Responsibilities:

  • 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 regulatory requirements and internal compliance standards.
  • Monitoring & Reporting: Track claim turnaround times, analyze claim outcomes, and prepare periodic reports on performance and trends.
  • Process Improvement: Identify inefficiencies in claims workflows and recommend process enhancements to improve speed, accuracy, and customer satisfaction.

Requirements:

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

Preferred Qualifications:

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

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.
  • Strong organizational skills and accountability.

Why This Role?

  • Be part of creating a vertical from scratch at a fast-growing organization.
  • Contribute to delivering a seamless, customer-focused experience.
  • Opportunity to grow and develop professionally in a dynamic environment.

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