Customer Care Executive

2 days ago

Bengaluru, Karnataka, India Ohealer Healthcare Services Full time ₹ 8,00,000 - ₹ 12,00,000 per year

Job Summary

As a Clinikk Healthcare Executive, you will be a trusted go-to resource who helps our subscribers with any issues related to their health or health benefits. Youll have the opportunity to help subscribers get the right care at the right time.

Responsibilities and Duties

Engage with subscribers - Take a holistic approach to subscriber interaction, understanding their needs & provide resolution through relevant communication channels such as Inbound/Outbound calls & Chat

Deliver interventions - Support subscribers to navigate the complex and confusing health care system and help them make smarter medical choices, by connecting with the right clinical resource. Leverage technology & internal resources to help understand the subscribers path, actions needed & next step

Drive better subscriber outcomes - Assist with improved financial outcomes by helping subscribers with appropriate health care usage; optimize their benefit packages & third party vendors

Delight subscribers - Create a personalized & memorable experience with Clinikk, build relationships through active listening, honesty & empathy.

Health Insurance Claims Handling:

Possess working knowledge of health insurance terminology and standard claims procedures. Handle both cashless and reimbursement claim processes, including form filling, document verification, submission, and timely follow-up with insurers and TPAs.

Act as a liaison between the customer and insurer: effectively communicate and relay any queries or requirements raised by the insurer to the subscriber in a clear, timely, and accurate manner.

Ensure complete documentation and follow-up for claim approval, track claim status, and escalate cases where needed to ensure swift resolution.

Support in guiding subscribers through pre-authorization, discharge processes, and post-hospitalization claims.

Maintain and update claim records accurately for internal reporting and audits.

Required Experience, Skills and Qualifications What we are looking for:

Language Proficiency in Kannada,English and Hindi is a must.

Strong command over written and verbal English with a focus on clarity and professionalism.

Ability to quickly understand and implement new processes and guidelines.

Bachelors Degree/Diploma or Experience in Hospital/Healthcare/Insurance environment

Ability to thrive in a performance based environment

Demonstrate high level of personal accountability

Demonstrated ability to use Microsoft Office (Word, XL,Google sheets,email)

Previous experience in a chat-based customer support role (minimum 1 year ).

Familiarity with ticketing systems and CRM tools is an advantage.

Desired Personal Characteristics:

Strong self-management

Excellent English written and verbal communication skills with proven ability to communicate with individuals at various levels within the organization

Ability to perform well under pressure, adapt to change, and meet deadlines in a fast-paced, dynamic, evolving environment

Change champion and adapt to change quickly

Data-driven and fact-based: focused on getting to best answer for clients

Detail-oriented, inquisitive, problem-solving in nature, Thrive in a team environment. A team player capable of collaborating with individuals throughout the organization.

We find joy and purpose in serving others. Making a difference in our members and customers' lives is what we do. Even when it's hard, we do the right thing for the right reason.

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