Chief Claim Resolution Specialist

5 days ago


Pune, Maharashtra, India beBeeLegalClaims Full time ₹ 1,04,000 - ₹ 1,30,878
Job Overview

As a Legal Claims Manager, you will be responsible for overseeing the life cycle of MACT and WC claims from start to finish. You will ensure effective coordination with advocates, timely referrals of awards, and take all necessary actions to ensure prompt claim settlements and legal defenses.

Key Responsibilities:
  • Manage MACT and WC claims life cycle end to end, including claim review, timely referral of awards, compromise referrals, payment release, and coordination with advocates for settlements and defenses.
  • Develop a clear line of action for claims and ensure all steps are taken to achieve favorable outcomes.
  • Attend court hearings to lead evidence presentations and take necessary steps to secure exonerations.
  • Travel for settlement discussions and advocate performance reviews, ensuring optimal claim resolutions.
  • Review claims cases, categorize them into defense and compromise categories, and maintain appropriate reserves.
  • Strive to settle cases promptly after thorough review and analysis to mitigate potential losses.
  • Maintain and report monthly closure data, ensuring timely resolution and tracking of ongoing claims.
Required Skills & Qualifications:
  • Bachelor's degree in Law (LLB); additional certifications in insurance law or related fields will be advantageous.
  • Minimum 5 years of experience in handling legal claims within the General Insurance industry, with strong expertise in MACT and WC claims.
  • Thorough understanding of insurance regulations, claim processes, and legal proceedings.
  • Proven experience in attending court hearings, leading evidence presentation, and coordinating settlements.
  • Ability to travel for settlements and performance reviews as required.
  • Strong analytical and negotiation skills, with the ability to categorize claims and make timely decisions.
  • Proficiency in MS Office, with excellent reporting and communication skills.


  • Pune, Maharashtra, India beBeeSettlement Full time ₹ 9,00,000 - ₹ 12,50,000

    Insurance Claim Settlement Specialist Job DescriptionThe role of an Insurance Claim Settlement Specialist is to manage the entire claims settlement process from submission to final resolution. The ideal candidate will assess claims, investigate their validity, coordinate with adjusters, and ensure timely and fair settlements.Key Responsibilities:Claims...


  • Pune, Maharashtra, India beBeeclaims Full time ₹ 15,00,000 - ₹ 28,00,000

    Job Overview:We are seeking a meticulous Claims Resolution Specialist to manage claims processing, supplier coordination, and credit/debit note handling.Key Responsibilities:Manage Claims/Tickets: Process and resolve claims utilizing SAP software.Request for Credit (RFC) Management: Create, track, and follow up on RFCs in conjunction with suppliers.Credit...


  • Pune, Maharashtra, India beBeeInsurance Full time ₹ 12,00,000 - ₹ 25,00,000

    Claims Resolution ExpertWe are seeking a highly skilled Claims Resolution Expert to fill this exciting opportunity.Key Responsibilities:Handle end-to-end processing of reimbursement claims for group medical corporate policies, ensuring timely and accurate resolutions.Provide exceptional customer service by addressing claims-related queries via various...


  • Pune, Maharashtra, India beBeeOncology Full time ₹ 8,00,000 - ₹ 15,00,000

    We are seeking an experienced professional with a strong background in oncology billing and collections. The ideal candidate should have at least 3 years of experience specifically in oncology, excellent communication skills, and the ability to handle complex claim resolutions.Responsibilities:Contact insurance companies to follow up on oncology-related...


  • Pune, Maharashtra, India Loop Health Full time

    We are looking for a Dedicated Claims Specialist with a strong background in medical and health insurance particularly in group medical corporate policies The ideal candidate should have 2-4 years of experience in claims processing or CRM roles Key Responsibilities Handle end-to-end processing of reimbursement claims for group medical corporate policies ...

  • Claims Specialist

    1 week ago


    Pune, Maharashtra, India Al Fahad Enterprises Full time ₹ 55,000 - ₹ 1,10,000 per year

    Salary - 5.5 lpaExp - 2-4 yearsRole DescriptionThis is a full-time on-site role for a Claims Specialist, located in Pune. The Claims Specialist will be responsible for managing and processing insurance claims, handling claim discrepancies, and ensuring timely settlements. The role involves daily tasks such as reviewing and analyzing claim submissions,...


  • Pune, Maharashtra, India beBeeClaims Full time ₹ 15,00,000 - ₹ 28,00,000

    Job Description:We are seeking a highly skilled Claims Specialist to join our team. As a Claims Specialist, you will be responsible for reviewing and processing death claims, maintaining accurate records, and providing excellent customer service.Key Responsibilities:Reviewing and matching beneficiary claim forms (death claims)Maintaining and reviewing death...


  • Pune, Maharashtra, India beBeeClaims Full time ₹ 8,00,000 - ₹ 12,00,000

    Job Title: Dedicated Claims Specialist We are seeking a highly skilled Dedicated Claims Specialist to join our team. As a key member of our insurance organization, you will play a vital role in handling end-to-end processing of reimbursement claims for group medical corporate policies. Key Responsibilities:    Handle all aspects of claim processing,...


  • Pune, Maharashtra, India beBeeAdministrative Full time ₹ 1,04,000 - ₹ 1,30,878

    Claims Administrator Position OverviewWe are seeking a highly skilled Claims Administrator to join our team. The successful candidate will possess strong analytical and communication skills, with the ability to work efficiently in a fast-paced environment.The primary responsibility of this role is to process and manage claims using SAP, ensuring accuracy and...


  • Pune, Maharashtra, India beBeeDenial Full time US$ 40,000 - US$ 60,000

    As a critical member of our team, we are seeking an experienced AR Calling Specialist to ensure accurate reimbursement for medical claims by contacting insurance companies and patients.Key Responsibilities:Follow-up and Resolution: Initiate calls to insurance companies to inquire about denied claims status.Documentation: Maintain thorough records of all...