Claims Resolution Expert

23 hours ago


Pune, Maharashtra, India beBeeInsurance Full time ₹ 12,00,000 - ₹ 25,00,000
Claims Resolution Expert

We 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 communication channels.
  • Analyze medical documentation, policy terms, and conditions to ensure accurate claim assessment and processing.
  • Liaise with internal teams, insurers, TPAs, and hospitals to ensure seamless claims settlement.
  • Manage claims escalations, ensuring prompt resolution while maintaining a customer-centric approach.

Requirements:

  • In-depth knowledge of corporate group medical insurance policies and claims processing procedures.
  • Ability to understand medical terminology, treatment procedures, and health-related documentation.
  • Proficient in customer support and claims management tools, including data analysis and problem-solving skills.
  • Strong communication and interpersonal skills to manage customer relationships and resolve issues effectively.
  • Attention to detail to ensure accuracy in claim processing and documentation review.
  • Ability to collaborate effectively with cross-functional teams.

Preferred Qualifications:

  • Bachelor's degree in healthcare, insurance, or related field.
  • 2-4 years of experience in claims processing, CRM role preferably within group medical corporate policies.


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