
Insurance Claims Specialist
5 days ago
We are seeking a dedicated and detail-oriented Health Insurance Claims Representative to join our team.
Job Summary:This role involves processing and evaluating health insurance claims with accuracy and fairness. You will verify policy coverage, eligibility, and supporting documents while maintaining records and following up on pending claims to ensure timely resolution.
As a Health Insurance Claims Representative, you will be responsible for coordinating with hospitals, TPAs, and policyholders for seamless settlement and communicating clearly with customers and providing updates on claim status.
Responsibilities:- Process and evaluate health insurance claims with accuracy and fairness.
- Verify policy coverage, eligibility, and supporting documents.
- Maintain records and follow up on pending claims to ensure timely resolution.
- Coordinate with hospitals, TPAs, and policyholders for seamless settlement.
- Communicate clearly with customers and provide updates on claim status.
- Experience in health insurance claims handling/management (TPA/insurer background preferred).
- Strong understanding of insurance processes & regulations.
- Excellent customer service & communication skills (written & verbal).
- Strong analytical, problem-solving & attention-to-detail abilities.
Be part of a growing organization that values its employees and provides opportunities for growth and development.
Make a real difference in customers' lives by providing excellent service and ensuring that their health insurance claims are processed efficiently and fairly.
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