
Health Insurance Claims Resolution Specialist
3 days ago
Job Description:
We are seeking an individual who is passionate about delivering exceptional customer experiences and ensuring seamless claim resolutions. In this role, you will serve as a bridge between customers, healthcare providers, and insurance organizations—handling claims with accuracy, empathy, and efficiency.
Responsibilities:
- Process and evaluate health insurance claims with precision and fairness.
- Verify policy coverage, eligibility, and supporting documentation.
- Coordinate with healthcare providers, third-party administrators, and policyholders to ensure timely settlements.
- Maintain accurate records and follow up on pending claims to ensure efficient resolution.
- Communicate clearly with customers and provide updates on claim status.
- Ensure compliance with regulatory requirements and company policies.
Requirements:
- Experience in health insurance claims handling or management (TPA/insurer background preferred).
- Strong understanding of insurance processes and regulations.
- Excellent customer service and communication skills (written and verbal).
- Strong analytical, problem-solving, and attention-to-detail abilities.
- Ability to work independently and collaboratively as part of a team.
- Bachelor's degree (Commerce, Healthcare, Insurance, or related field preferred).
Why Join Our Organization?
- Be part of a dynamic organization that prioritizes people and delivers exceptional results.
- Opportunity to make a positive impact on customers' lives through efficient claim resolution.
- Collaborative work culture with opportunities for growth and development.
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