Cashless Claims Processor

2 days ago

Malappuram, Kerala, India beBeeClaims Full time ₹ 7,20,000 - ₹ 13,80,000

Job Overview:

We are seeking a skilled Cashless Claims Processor to join our team. In this role, you will be responsible for efficiently and accurately processing cashless insurance claims.

The ideal candidate will have excellent communication skills, attention to detail, and the ability to work well under pressure.

The job involves verifying policy coverage, reviewing medical records, coordinating with Insurers, and ensuring that claims are processed accurately and efficiently.

The successful candidate will have a strong focus on customer service, ensuring high Net Promoter Score (NPS) in the cashless claims handled.

Key Responsibilities:

  1. Manage End-to-End Cashless Claims: Process end-to-end cashless claims of employees, verifying policy coverage, reviewing medical records, coordinating with Insurers, and ensuring accurate and efficient processing.
  2. 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.
  3. Provide Customer Service: Respond to inquiries from employees and other stakeholders regarding claim status and any related queries.
  4. Coordinate with Healthcare Providers/Hospitals: Communicate with healthcare providers to obtain additional information, clarify details, and resolve issues.
  5. Resolve Issues: Investigate and resolve discrepancies, errors, or issues that may arise during the processing of cashless claims.
  6. Maintain Records: Keep detailed and accurate records of all claim-related activities, communications, and transactions for documentation and audit purposes.
  7. Meet Performance Metrics: Meet or exceed established performance metrics related to claim processing, turnaround time, accuracy, and customer satisfaction.

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