Claims Specialist

Job Title:- Sr. Executive - Insurance

Location: Gurugram, Sector - 14

Experience: 2-3 years

Salary: As per market standards

Working Days: 6

Shifts and Week-Offs: Rotational

Eligibility:

• Any Graduate

• Prior Hospital Background Preferred

Position Overview:

We are seeking a detail-oriented Insurance Executive to oversee accurate and timely patient billing. The role involves coordinating with medical teams and insurance providers, validating documentation, resolving billing queries, and ensuring smooth desk operations.

Key Responsibilities:

● Policy Review & KYP Verification: Review and validate policy information under the Know Your Policy (KYP) process, ensuring customer details, policy terms, and documentation are accurate and complete.

● Insurance Terminology & Policy Interpretation: Interpret key insurance components such as premiums, sum insured (SI), deductibles, co-pay, exclusions, waiting periods, riders, endorsements, underwriting notes, and overall policy structure.

● Coordination with Customers, TPAs & Internal Teams: Liaise with customers, TPAs, and internal

departments for clarifications, document follow-ups, and smooth handling of policy-related or

claims-related processes.

● Discrepancy Resolution & Compliance Management: Identify discrepancies in policy data, ensure timely rectifications, and maintain accurate records in compliance with operational, regulatory, and audit standards.

● Claims, Cashless & Billing Support: Support insurance operations including cashless approvals, claims flow understanding, and preparation of accurate patient billing with correct documentation and coding.

Skills we value:

• Basic Excel Knowledge

• Medical Billing Knowledge

About Hexa Health:

At HexaHealth, we are building a platform that will help users choose the right hospital/surgeon for their surgical procedure. We are working towards building India's largest hospital network, and we will ensure a hassle-free experience for the patient at the hospital.

Website Link: https://www.hexahealth.com/

LinkedIn Link: https://www.linkedin.com/company/hexahealth/

Careers Page Link: https://www.hexahealth.com/careers

Whatsapp Channel Link: https://whatsapp.com/channel/0029VaLmR8IL7UVQUeKlZQ1O