UpSpike Healthcare

We are seeking an experienced Health Insurance Claims Management professional to join our dynamic team in a fully remote capacity. This role offers excellent growth potential with performance-based compensation that rewards efficiency and excellence in claims processing. Job Details Position Type: Full-time, Remote Department: Claims Management Reports to: Director Compensation Package Base Salary: INR 10,000 per month Performance Pay: INR 5,000 - INR 50,000 per month (based on number of claims processed) Total Potential Earnings: INR 15,000 - INR 60,000 per month Key Responsibilities Process and manage health insurance claims efficiently and accurately Review claim documentation and verify coverage eligibility Coordinate with healthcare providers, policyholders, and internal teams Handle cashless claim approvals and settlements Maintain detailed records of all claim activities Ensure compliance with regulatory requirements and company policies Investigate and resolve claim discrepancies Provide excellent customer service throughout the claims process Meet monthly productivity targets for claim processing Generate reports on claim status and processing metrics Required Qualifications Minimum 2 years of experience in health insurance claims management Mandatory experience with Cashless Everywhere/Anywhere Cashless systems and processes Strong understanding of health insurance policies and procedures Knowledge of medical terminology and coding systems Proficiency in claims management software and databases Excellent analytical and problem-solving skills Strong attention to detail and accuracy Effective communication skills (written and verbal) Ability to work independently in a remote environment Bachelor's degree preferred (relevant experience may substitute) Preferred Qualifications Experience with multiple insurance carriers and TPA systems Knowledge of regulatory compliance requirements Previous experience in a remote work environment Certification in health insurance or claims management Technical Requirements Reliable high-speed internet connection Dedicated workspace for remote work Proficiency in MS Office Suite Ability to learn new software systems quickly Performance Metrics Monthly compensation will be determined based on: Number of claims processed per month Accuracy rate in claim processing Customer satisfaction scores Turnaround time for claim resolution Compliance with quality standards What we offer Competitive performance-based compensation structure Flexible remote work arrangement Professional development opportunities Supportive team environment Growth potential within the organization Application Process Interested candidates should submit their resume along with a cover letter highlighting their experience with cashless claim management systems at hr@upspike.in . Please include specific examples of your achievements in claims processing and your familiarity with Cashless Everywhere/Anywhere Cashless platforms.