
Insurance Claim Resolution Professional
3 days ago
Job Summary:
The primary function of a Claims Resolution Specialist is to manage the process of resolving insurance claims in an efficient and timely manner. The specialist will be responsible for ensuring that all relevant information is collected and verified, and that policyholders receive timely updates on the status of their claims.
This role involves close collaboration with internal stakeholders such as the Onboarding team, Products & engineering, Claims teams, Support Inbound, Account Management, as well as external clients including Insurers, Client HRs, and Hospitals.
Key Responsibilities include:
- Verifying Policy Coverage: Reviewing and verifying policy details to ensure eligibility for cashless processing.
- Managing End-to-End Claims: Ensuring timely closure of cashless insurance claims and seamless coordination with insurance providers.
- Providing Customer Service: Responding to inquiries from employees and stakeholders regarding claim status and other related queries.
- Coordinating with Healthcare Providers/Hospitals: Obtaining additional information, clarifying details, and resolving discrepancies during claim processing.
- Resolving Issues: Investigating and resolving discrepancies, errors, or issues that arise during claim processing.
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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