2.0 - 6.0 years

0 Lacs

pune, maharashtra

On-site

As a Dedicated Claims Specialist, you will be responsible for handling end-to-end processing of reimbursement claims for group medical corporate policies. You should possess a strong background in medical and health insurance, with a focus on group medical corporate policies. The ideal candidate for this role will have 2-4 years of experience in claims processing or CRM roles. Your key responsibilities will include providing excellent customer service by addressing claims-related queries via platforms such as Freshchat, Ozontel, and Freshdesk. You will be required to analyze medical documentation, policy terms, and conditions to ensure accurate claim assessment and processing. Additionally, you will need to liaise with internal teams, insurers, TPAs, and hospitals to facilitate seamless claims settlement and timely resolutions. Managing claims escalations and ensuring prompt resolution while maintaining a customer-centric approach will also be part of your role. To excel in this position, you must have in-depth knowledge of corporate group medical insurance policies and claims processing. Understanding medical terminology, treatment procedures, and health-related documentation is essential. Proficiency in customer support and claims management tools like Ozontel, Freshdesk, or similar platforms is required. Strong communication and problem-solving skills are necessary to effectively manage customer relationships and resolve issues. Attention to detail is crucial to ensure accuracy in claim processing and documentation review. Collaboration with cross-functional teams, including insurance partners and hospital networks, is key to success in this role. Qualifications for this position include a Bachelor's degree in healthcare, insurance, or a related field. A minimum of 2-4 years of experience in claims processing or CRM roles, preferably within group medical corporate policies, is preferred.,

Posted 2 days ago

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