Claims Executive

Location: Powai, Mumbai (Preferred candidates from nearby)

Experience: Minimum 2 Years

Salary: up to 3.5 LPA

Reporting to: Megha N Sr Claims Executive

Working Hours: 10:00 AM 6:30 PM (Two Saturdays off per month)

Employment Type: Full time

Job Overview: We are looking for a diligent and detail-oriented Claims Executive to handle health, motor, and non-motor insurance claims for both corporate and retail clients The ideal candidate should ensure timely and accurate settlements maintain clear communication with all stakeholders and deliver exceptional customer service while adhering to all regulatory and compliance guidelines.

Key Responsibilities:

• Process and manage health, motor (and non-motor insurance claims).

• Review physical and digital claim files, verify documentation, and ensure proper file management.

• Coordinate with insurers, TPAs, internal/external surveyors for claim updates and resolutions.

• Respond to client queries, follow up for missing documents, and provide status updates.

• Ensure timely claim processing within the defined Turnaround Time (TAT).

• Review settlement letters for any errors or unjust deductions.

• Facilitate cashless claim approvals through coordination with hospitals and internal cashless teams.

• Assist clients in filing ombudsman complaints for unfairly rejected claims.

• Maintain digital claim records and update closure entries in Saiba.

• Support urgent cashless claims during weekends or off hours when required.

• Attend to walk in queries and provide personalized support to HNI clients.

Outdoor Visits:

•Visit hospitals to support HNI clients during cashless claims.

•Handle claims processing in the absence of other team members.

•Ensure timely email responses and maintain digital records of all documents.

Qualifications

•Graduate (Preferred Insurance, Healthcare, or Business-related field).

•Minimum Experience 2 years in insurance claims processing.

•In depth knowledge of insurance policies, TPAs, claim life cycles, and regulatory compliance.

Key Skills:

•Excellent verbal and written communication skills in English.

•High level of accuracy and attention to detail.

•Strong time management and organizational skills.

•Ability to work both independently and in a team.

•Customer centric approach with a proactive problem-solving attitude.

•Proficiency in using Microsoft Office tools (Word, Outlook).

•Good understanding of insurance claim cycles, documentation standards, and regulatory norms.

Compensation Benefits:

• Competitive salary package in line with market standards,

• Group Medical Insurance (GMC) coverage,

• Annual performance-based increment eligibility,

Application Process

Interested candidates can share their updated profiles with the subject line

“[JobTitle]Title] ––[Your Name]” at proactive@smgroup work

For queries, contact +91 8850694865

Job Types: Full-time, Permanent

Pay: ₹10,041.93 - ₹34,666.29 per month

Benefits:

• Health insurance

Schedule:

• Day shift

Supplemental Pay:

• Performance bonus

Work Location: In person

Speak with the employer
+91 08850694865