Claim Facilitator Representative- Senior Executive/Assistant Manager

4 days ago


Bengaluru Chennai Hyderabad, India Bwise Solutions Full time ₹ 24,00,000 - ₹ 48,00,000 per year

*HJealth insurance Open position*

Location

Bangalore-1

Hyderabad-2

Chennai-1

*CTC: Upto 5.0 LPA*

Age: Max 35

JOB PROFILE

Position - Claim Facilitator Representative- Senior Executive/Assistant Manager

JOB SUMMARY:

  • Responsible to Investigate Cashless/Spot and Reimbursement Claims in field.

KEY RESPONSIBILITIES:

  • Cashless & Spot cases need to be investigated within 24 hours from the allocation date.
  • Reimbursement cases need to be investigated within 15 days from the allocation date.
  • Pre Quality Check of Cashless and Reimbursement Claims for further investigation and Closure of his own cases.
  • Need to check Previous claims documents also before doing the investigation
  • Adhere to agreed TAT and accuracy
  • Should highlight Central team with Fraud Proven Hospital names on basis of his findings and market feedback.
  • Cases reports to be Prepared with Quality.
  • Maintain Daily Sheet of all the Investigation Cases
  • Coordination with within different function
  • Ability to work in highly competitive & demanding environment

KEY STAKEHOLDERS

Internal:

  • Customer Service and Operations Team
  • Claims Team

MEASURES of Success:

  • Fraud Proven %
  • TAT
  • Quality of investigation
  • Productivity

QUALIFICATION & EXPERIENCE:

  • Any Graduate from any Background (Medical Background Preferred)
  • 1-2 Years Experience in Field Investigation
  • Knowledge of Insurance Industry
  • Knowledge in Computer & MS Office
  • Excellent Interpersonal and team working skills

KEY COMPETENCIES & SKILLS REQUIRED

  • Investigation skills
  • Knowledge of Insurance

* For More Details, Contact:*

Ishika (HR) –


  • Claims Executive

    5 hours ago


    Mahatma Gandhi Road, Bengaluru, Karnataka, India Disha Capital Insurance Brokers Full time

    **Claims Executive - EB** - **Job Summary**: We are seeking a qualified Claims executive to help our clients in claims and any other query solution through their own skills. Our ideal Claims executive has to have indepth knowledge of and experience with the Claim process, Policy terms and conditions, relationship building and MIS management. We are seeking a...

  • Claims Representative

    2 weeks ago


    Hyderabad, Telangana, India nimble International Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    Why work at nimble?This is a great opportunity to join a well-established and market-leading brand serving a high-growth end market while gaining valuable experience working closely with Executive leadership. As an organization, we are in high-growth mode through acquisition with a laser focus on positive culture building Who we arenimble solutions is a...

  • Claims Executive

    2 weeks ago


    Bengaluru, Pune, India Digit Insurance Full time ₹ 1,04,000 - ₹ 1,30,878 per year

    Process and review Life insurance claims, ensuring adherence to company policies and guidelines.Verify claim documentation, including Death certificate , Employment details, medical records to rule out cause of death and co-morbidities, PMR, FIR , and other supporting documents.Examine insurance applications and documents to ensure accuracy.Communicate with...


  • Bengaluru, Karnataka, India The Cigna Group Full time ₹ 2,00,000 - ₹ 5,00,000 per year

    Job Profile -Claims Associate Representative: Band 1Job Description –Have a passion for solving problems? Dedicated to improving the customer experience? Love digging in to research and analyse complex issues?The Claims Associate Representative's primary responsibility is to process and complete customer and provider submitted claims. Deliver basic...


  • Bengaluru, Karnataka, India The Cigna Group Full time

    **Job Profile -** Claims Associate Representative: Band 1 **Job Description -** Have a passion for solving problems? Dedicated to improving the customer experience? Love digging in to research and analyse complex issues? The Claims Associate Representative’s primary responsibility is to process and complete customer and provider submitted claims....

  • Business Facilitator

    2 weeks ago


    Bengaluru, Karnataka, India Sambhav Foundation Full time

    Got it! Here's the updated job posting with the new roles and requirements: **Job Opportunities at Sambhav Foundation** Sambhav Foundation is hiring for multiple positions across various business and finance sectors. We provide comprehensive training and placement assistance to ensure your success in your chosen career. If you're looking to start or advance...


  • Hyderabad, Telangana, India nimble International Full time

    Description: **Why work at nimble?** This is a great opportunity to join a well-established and market-leading brand serving a high-growth end market while gaining valuable experience working closely with Executive leadership. As an organization, we are in high-growth mode through acquisition with a laser focus on positive culture building! **Who we...


  • Bengaluru, Karnataka, India Cigna Healthcare Full time ₹ 4,00,000 - ₹ 8,00,000 per year

    About UsAt CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day.One of the keys to driving Responsible Growth is being a great place to work for our...


  • Hyderabad, Telangana, India Optum Full time

    Imagine this. Everyday, in claims centers around the world, UnitedHealth Group is processing and resolving payment information for millions of transactions. Would you think we have some great technology? Would you think we know how to manage volume? You would be right. No one's better. And no company has put together better teams of passionate, energetic and...


  • Bengaluru, Karnataka, India The Cigna Group Full time

    **About US** At CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our...