Health Insurance Claims Professional

6 hours ago


Kollam, Kerala, India beBeeClaims Full time ₹ 9,00,000 - ₹ 15,00,000

Transforming lives through precise health insurance claims management

About the Role

We seek a seasoned Health Insurance Claims Manager to oversee and coordinate the end-to-end claims process for our clients. This is an opportunity to excel in a fast-paced environment, working closely with clients, insurers, third-party administrators (TPAs), and healthcare providers to ensure seamless, accurate, and timely claim resolutions.

The ideal candidate will have extensive experience in health insurance claims management, possess exceptional problem-solving skills, and be able to deliver a customer-centric experience.

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, 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 guidelines, insurer protocols, and internal compliance standards.
  • Monitoring & Reporting: Track claim turnaround times, analyze claim outcomes, and prepare periodic reports on performance and trends.

Requirements

Education

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

Experience

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

Certifications

  • IRDAI Health Insurance certification or equivalent preferred.

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.

Benefits

Join us and discover a culture that values guidance over pressure, empowering families to make confident decisions.

We offer a dynamic work environment where you'll have opportunities to build something new, grow professionally, and thrive in a collaborative atmosphere.



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