
Health Insurance Claims Management Professional
16 hours ago
Are you a detail-oriented and organized professional looking for a challenging role in health insurance claims management?
Job DescriptionWe are seeking an experienced Health Insurance Claims Manager to oversee the end-to-end claims process for our customers.
You will serve as the primary liaison between clients, insurers, third-party administrators, and healthcare providers to ensure claims are handled smoothly, accurately, and on time.
The ideal candidate will have a strong background in health insurance claims management, excellent problem-solving skills, and the ability to deliver a seamless, customer-focused experience.
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, third-party administrators, 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, insurer protocols, and internal compliance standards.
- Bachelor's degree in Business, Finance, or related field.
- 3–6 years of proven experience in health insurance claims management or related roles.
- Relevant certifications preferred.
- 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.
- Customer-first mindset with empathy and professionalism.
- Ability to work under pressure and meet deadlines.
- Strong organizational skills and accountability.
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