Claims Associate

Job Description

Job Title: Claims Support AssociateAbout Flip HealthGood Health Drives Great Work! Founded in 2021, Flip Health leverages technology and healthcare expertise to provide 360-degree healthcare at economical prices, without the need for insurance. With Flip Health, organizations are empowered with the tools to build a healthier workforce - with unlimited doctor consultations, lab tests, chronic care, mental health, and much more, all covered in a single membership. Good Health is just a click away! We are seeking an experienced Claims Support Associate to join our Customer support team. In this role, you will be responsible for managing customer inquiries and issues related specifically to claims processes. Additionally, you will be responsible for providing internal support via outbound communication to our users to support claim submissions. The ideal candidate should have a strong healthcare & claims processing background, excellent communication skills, and a passion for providing exceptional user service, particularly in resolving claims-related concerns. Responsibilities:Provide timely and professional assistance to users regarding claims processes through phone, email, and chatProactively engage in outbound communication with users to guide them through claim submission requirements and resolve any issuesDevelop a deep understanding of the company’s claims procedures and services to address user inquiries effectivelyIdentify, troubleshoot, and resolve claims-related issues, striving for first-contact resolution whenever possibleMonitor and detect potential fraudulent claims by reviewing claims submissions for accuracy and consistency, escalating suspicious cases to the senior team for further investigationEscalate complex or unresolved claims problems to the senior team when necessaryMaintain accurate and comprehensive records of user claims interactions, including inquiries, complaints, and resolutions in the CRM system/Excel spreadsheetShare user feedback and insights with the senior team to help improve the claims process and service offeringsContribute to the ongoing development and updating of the claims support knowledge base, ensuring it contains accurate and helpful information for usersEnsure high-quality service standards by adhering to established claims policies and procedures, and participating in regular training and development programsCollaborate with colleagues and senior team members to address claims-related issues efficiently, and share knowledge to enhance team performanceMaintain clear and effective communication with users, keeping them informed of the status of their claims throughout the resolution processStrive to meet or exceed customer satisfaction goals and actively work to improve the overall claims experienceEnsure compliance with all necessary regulations related to claims support, processing, and fraud detection Requirements:1-3 years of relevant experience, preferably in healthcare or a service-based companyStrong verbal and written communication skills to interact with customers professionally and effectivelyProven problem-solving abilities to handle claims inquiries and resolve issuesAbility to demonstrate patience and empathy when dealing with claims concerns or disputesWillingness to collaborate with team members and contribute to a positive and productive team environmentFlexibility to adapt to changing priorities and new tools or processes as requiredCommitment to delivering excellent customer service, with a strong focus on claims supportEffective time management skills to handle multiple customer claims and tasks simultaneouslyAttention to detail to ensure accurate documentation of claims interactions and data integrityWillingness to work in rotating shiftsFluent in at least three languages, with mandatory fluency in English and Hindi, along with any other local language Why Flip Health?Our users trust us with the enormous responsibility of helping them manage their healthcare. We work tirelessly to be worthy of that trust and we make sure our team is well-supported so we can deliver on this promise. This position is on-site, with the work location in Hyderabad. Our office is based in Hyderabad, Telangana. If this sounds like the right fit for you, please email careers@flip.health with your resume (a short cover letter would be greatly appreciated) in PDF format. Please note that an assignment may be a part of the interview process.We are proud of the diversity at Flip Health and continually seek diverse perspectives to enrich our team. Let’s revolutionize modern healthcare together!