Claim Process Associate

8 hours ago

Mysuru Karnataka, India SAS Poorna Arogya Health Care Pvt Ltd Full time

The Claims Process Associate is responsible for managing and processing insurance claims by reviewing documentation, verifying details, and ensuring claims are processed in a timely and accurate manner. The role involves communication with customers, insurers, and other parties to resolve issues and ensure claims are settled appropriately.

**Key Responsibilities**:

- Review and assess claims for completeness and accuracy.
- Process incoming claims, ensuring all necessary documentation is provided.
- Verify the details of claims and liaise with policyholders, medical providers, and third parties as needed.
- Investigate claims to ensure compliance with policies and regulations.
- Resolve discrepancies in claims by requesting additional information or clarification.
- Communicate with customers and clients to explain claim statuses, requirements, or outcomes.
- Maintain accurate records of all claims, actions taken, and outcomes.
- Work closely with other departments (e.g., underwriting, customer service) to ensure smooth claim processing.
- Ensure adherence to company procedures, legal requirements, and deadlines.
- Resolve claims-related inquiries and complaints.

**Qualifications**:

- bachelor's degree in relevant field
- Basic understanding of insurance policies and procedures is a plus.

**Skills**:

- Proficiency in Microsoft Office and claims management software.
- Strong analytical and problem-solving abilities.
- Excellent written and verbal communication skills.
- Ability to work independently and in a team-oriented environment.

Schedule:

- Day shift

**Education**:

- Bachelor's (preferred)

Work Location: In person

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