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Plumhq
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Customer Success Executive, Reimbursement Claim

Customer Success Executive, Reimbursement Claim

Plumhq

0 - 4 years

2 - 6 Lacs

Bengaluru

Posted:4 weeks ago| Platform:

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Skills Required

Health insurance Team leading Claims Insurance claims Healthcare Account management Customer service Claims processing Principal Auditing

Work Mode

Work from Office

Job Type

Full Time

Job Description

About Plum

Plum is an employee insurance and health benefits platform focused on making health insurance simple, accessible and inclusive for modern organizations.

Healthcare in India is seeing a phenomenal shift with inflation in healthcare costs 3x that of general inflation. A majority of Indians are unable to afford health insurance on their own; and so as many as 600mn Indians will likely have to depend on employer-sponsored insurance.

Plum is on a mission to provide the highest quality insurance and healthcare to 10 million lives by FY2030, through companies that care. Plum is backed by Tiger Global and Peak XV Partners.

About the role

The primary job purpose of an Executive Reimbursement Claim Processor is to accurately and efficiently process reimbursement claims submitted by policyholders for medical expenses covered under their health insurance policies. This role plays a critical part in ensuring that policyholders receive timely payments for eligible medical costs incurred.

PRINCIPAL ACCOUNTABILITIES

Processing of reimbursement insurance claims, ensuring adherence to company policies and Terms & conditions of the policy.
Responsible for the following transactional activities
Scrutiny of reimbursement claims
Submission to Insurer
Informing incomplete documentation requirement to the employees
Liaising with employees in explaining the reason for requirements/plum rejections
Leading team of claims experts who guides the employees to submit the claims
Collaborating with internal& external stakeholders, such as Onboarding team, endorsements team Account management team to resolve complex claims issues and ensure a seamless claims submission
Communicating with Insurance companies policyholders, and internal departments to gather necessary information and resolve claim discrepancies
Maintaining accurate records of claims processing activities and documentation for audit and reporting purposes.
Providing customer service support to address inquiries and concerns related to reimbursement claims.
Working with Insurance companies to ensure that eligible claims are paid completely to the end customer

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Customer Success Executive, Reimbursement Claim