Claims Executive

6 days ago

Anna Nagar Chennai Tamil Nadu, India Link K Insurance TPA Pvt Ltd Full time

**Greetings From Link - K Insurance TPA**

We are hiring **Claims Executive** for our claims Department at our Chennai Corporate office.

**Year of Experience**: 1 to 3 Years

**Qualification**: Any Degree

**Industry**: TPA or Health Insurance (Indian Based Claims )

**Shift Timing**: 1 PM till 9 PM

**Roles and Responsibility**
- Accurate and efficient processing of claims, including verifying policy coverage, assessing claim validity, and calculating the appropriate payable amount.
- Get fully trained in claims software and complete understanding of features and validations in the system
- Get good understanding of process flow, movement of claim and stakeholders expectations w r t claims services
- Accurate data entry of bills into appropriate columns/fields
- Verify the accuracy of details entered at inward level and correcting wherever required.
- Adhere to SoPs defined
- Processing the number of claims allocated. Prioritizing claims as required.
- Be updated about the new products and features in health policies
- Interaction with customer service team and help with any clarifications in billing
- Ensure clarity in communication to customers.
- Identify and report potential fraudulent claims, following established procedures and guidelines.
- Coordinate with doctors and CRMs to aid in assessing claims accurately.
- Maintain daily report of claims processed and report to team lead.
- Actively participate in training sessions and workshops to enhance knowledge of insurance products, claims processing techniques, and industry developments.
- Assist medical officers in responding to audit queries of insurers.

**Job Types**: Full-time, Permanent

Schedule:

- Day shift
- Morning shift

**Experience**:

- cashless and reimbursement health insurance: 1 year (required)

Work Location: In person

**Speak with the employer**
+91 8428417047

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