Serve as the primary point of contact for all insurer interactions and internal support queries.
Resolve escalations and address claim-related issues promptly.
Manage end-to-end reimbursement claim processing including documentation, verification, and settlement.
Prepare and share cashless debit notes with insurers; follow up for approvals and payment status.
Build and maintain strong working relationships with Health & General Insurance companies.
Coordinate with insurers on policy, claim issues, and process improvements.
Monitor performance metrics including claim turnaround time (TAT) and SLA adherence.
Identify delays, gaps, and inefficiencies and implement corrective actions.
Prepare periodic MIS reports on claim performance, TAT, trends, and exceptions.
Support initiatives to optimize claim workflows, enhance efficiency, and improve customer satisfaction.
4–5 years of experience in Claims Handling or Insurance Operations.
Experience in health insurance, general insurance, or TPA operations preferred.
Bachelor’s degree in any discipline (preferred: Insurance, Healthcare, Business Administration).
Strong knowledge of reimbursement and cashless claims.
Excellent insurer relationship and coordination skills.
Familiarity with TAT/SLA monitoring and regulatory compliance.
Proficiency in MS Office and claims management/CRM systems.
Strong communication skills—written & verbal.
Analytical mindset and strong problem-solving skills.
Ability to handle escalations and work in a fast-paced environment.