Strategic Accounts Servicing team (SAS)

As a member of the Strategic Accounts Servicing Team at Plum, your role is crucial in ensuring the smooth processing and servicing of health claims for key strategic accounts. Your primary responsibility is to manage end-to-end cashless/reimbursement claims of employees, providing exceptional service tailored to each client's unique needs. You will act as a Claims buddy, verifying policy coverage, reviewing medical records, coordinating with insurers, and communicating with end customers to ensure accurate and efficient claims processing. Your attention to detail is essential in reviewing and verifying policy details to confirm claim eligibility based on insurance policy terms and conditions. In your role, you will respond to inquiries from customers and stakeholders regarding claim status, coordinate with healthcare providers and insurance companies to obtain necessary information, and resolve any discrepancies or issues that may arise during the claims processing. Your proactive communication with employees on claim status will contribute to a positive experience for all stakeholders involved. Maintaining detailed and accurate records of all claim-related activities is crucial for documentation and audit purposes. You will be expected to meet or exceed established service level agreements and performance metrics related to claim processing, turnaround time, accuracy, and customer satisfaction. Your goal is to achieve a Net Promoter Score (NPS) of 90+ in the claims you handle. To excel in this role, you should have at least 2-4 years of experience in a Health Insurance claims role. Excellent written and verbal communication skills are essential, as well as a background in customer service with a focus on direct customer management. Your commitment to optimizing claims processing workflows, enhancing client satisfaction, and supporting the organization's strategic goals will be key to your success at Plum.,