
Senior Insurance Claims Analyst
2 days ago
We are seeking a highly skilled Claims Specialist to join our team.
Job SummaryThis is a challenging and rewarding role that involves processing and managing cashless insurance claims efficiently and accurately, ensuring timely closure to policyholders and seamless coordination with insurance providers.
Key Responsibilities- Cashless Claims Management: Manage end-to-end cashless claims of employees, verifying policy coverage, reviewing medical records, coordinating with Insurers, and ensuring accurate and efficient processing.
- Policies Verification: Verify 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.
- Customer Service: Respond to inquiries from employees and other stakeholders regarding claim status and related queries.
- Healthcare Provider Coordination: Communicate with healthcare providers to obtain additional information, clarify details, and resolve issues.
- Issue Resolution: Investigate and resolve discrepancies, errors, or issues that may arise during claim processing to ensure timely and accurate resolution.
- Record Keeping: Keep detailed and accurate records of all claim-related activities, communications, and transactions for documentation and audit purposes.
- Service Level Agreements: Meet or exceed established service level agreements and performance metrics related to claim processing, turnaround time, accuracy, and customer satisfaction.
The ideal candidate will have at least 2 years of experience in customer-facing roles, with past experience in voice profiles and cashless/TPA being an added advantage.
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