Claim Associate - Health Claims TPA

2 - 6 years

6 Lacs

Posted:4 days ago| Platform: Naukri logo

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Work from Office

Job Type

Full Time

Job Description

Claims Associate Health Claims TPA

Position Description

Support end-to-end coordination and execution of health claims serviced via Third Party Administrators (TPAs). Ensure timely claim closures, partner communication, and customer satisfaction while maintaining internal SLAs and service quality.

Key Responsibilities

  • Ensure

    processing of all TPA claims within the defined TAT

    by actively tracking, following up, and resolving pending cases.
  • Conduct

    daily huddles with TPA partners

    to monitor outstanding claims and provide timely guidance for resolution.
  • Manage and resolve

    customer grievances and escalations

    received via calls and emails, ensuring closure within agreed timelines.
  • Respond to and

    clear all daily tickets and email queries

    with detailed resolutions, adhering to specified TATs.
  • Collaborate with internal teams for issue resolution and smooth claim workflows.
  • Maintain quality documentation of communications and follow-ups.

Experience & Skills Required

  • Experience:

    1–2 years of relevant experience in a similar role, preferably within

    Digit

    .
  • Internal Systems:

    Familiarity with Digit’s health claims processes and system workflows is essential.
  • Technology:

  • Working knowledge of

    Microsoft Excel

  • Comfort in navigating ticketing/email systems
  • Behavioural Traits:

  • Effective

    communication

    skills
  • Assertive

    yet empathetic handling of escalations
  • Proactive

    approach to claim follow-up and issue resolution

Education & Qualification

  • Qualification:

    Graduation in any stream
  • Preferred Background:

    Healthcare, insurance, or customer service roles

What You Bring to Digit

You ensure every travel claim is handled with speed, accuracy, and empathy, making stressful journeys easier for our customers.

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Digit Insurance

Insurance

Bengaluru Karnataka

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