Careers | Insurance Claim Specialist

16 hours ago

Udaipur, Rajasthan, India beBeeClaimsManagement Full time ₹ 10,46,800 - ₹ 15,61,500

About the Position:

The role of Claims Management Professional involves efficiently and accurately processing and managing cashless insurance claims to ensure timely closure to policyholders and seamless coordination with insurance providers.

This position requires verifying policy coverage, reviewing medical records, coordinating with Insurers, and ensuring that claims are processed accurately and efficiently. The professional may also be responsible for communicating with employees or dependants to provide updates on the status of their claims and to address any questions or concerns.

Key Responsibilities Include:

  • Managing end-to-end cashless claims of employees, verifying policy coverage, reviewing medical records, and coordinating with Insurers.
  • Verifying Policy Coverage: Review and verify policy details to ensure that the claim is eligible for cashless processing according to the terms and conditions of the insurance policy.
  • Providing Customer Service: Respond to inquiries from employees, and other stakeholders regarding claim status, and any other related queries.
  • Coordinating with Healthcare Providers/Hospitals: Communicate with healthcare providers to obtain additional information, clarify details, and resolve issues.
  • Maintaining Records: Keep detailed and accurate records of all claim-related activities, communications, and transactions for documentation and audit purposes.
  • Achieving Service Level Agreements: Meet or exceed established service level agreements and performance metrics related to claim processing, turnaround time, accuracy, and customer satisfaction.

Interactions:

  • Internal Clients: Endorsement team, Onboarding team, Products & engineering, Claims teams, Support Inbound, Account Management
  • External Clients: Insurers, Client HR's, Hospitals

Requirements:

  • At least 2 years of experience in customer-facing roles
  • Past Experience in voice profile would be an added advantage
  • Experience in cashless/ TPA

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