
Benefits Administrator
7 days ago
At our organization, we're looking for an experienced Health Insurance Claims Manager to oversee the end-to-end claims process. This individual will serve as the primary liaison between clients, insurers, third-party administrators, and healthcare providers to ensure claims are handled efficiently.
The ideal candidate will have a strong background in health insurance claims management, excellent problem-solving skills, and the ability to deliver a seamless customer experience. This is a full-time role based on-site with immediate joining.
Key Responsibilities:
- Claims Processing & Adjudication: Manage the complete lifecycle of health insurance claims, including verification, documentation, submission, follow-up, and settlement.
- Customer Coordination: Assist and guide customers through the claims journey, ensuring forms and documents are accurate, complete, and submitted promptly.
- Insurance & TPA Liaison: Collaborate with insurers, third-party administrators, and hospitals to ensure quick and accurate claim resolutions.
- Issue Resolution: Handle escalations, rejections, and disputes by investigating discrepancies, clarifying benefits, and negotiating fair outcomes for clients.
- Compliance & Accuracy: Ensure claims handling aligns with IRDAI guidelines, insurer protocols, and internal compliance standards.
- Monitoring & Reporting: Track claim turnaround times, analyze claim outcomes, and prepare periodic reports on performance and trends.
- Process Improvement: Identify inefficiencies in claims workflows and recommend process enhancements to improve speed, accuracy, and customer satisfaction.
Requirements:
- Bachelor's degree in Business, Finance, or related field.
Experience:
- 3–6 years of proven experience in health insurance claims management or related roles.
Skills:
- Strong knowledge of health insurance policies, products, and claims procedures.
- Excellent communication, negotiation, and customer-handling skills.
- High attention to detail with strong analytical and problem-solving abilities.
Attributes:
- Customer-first mindset with empathy and professionalism.
- Ability to work under pressure and meet strict deadlines.
- Strong organizational skills and accountability.
Why Join Us?
We provide guidance, not pressure—helping families make confident decisions. You'll be part of creating a vertical from scratch at a fast-growing fintech, working in a culture built on trust, transparency, and honesty.
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