Pune, Maharashtra, India
Posted on Thursday, February 23, 2023
We are hiring a Claims Specialist to help us maintain 100% retention and high-satisfaction in our health insurance clients. This person is customer-obsessed, is highly supportive and empathetic towards patients, and will help us scale our account management and client servicing teams in the years to come.
Roles and responsibilities
- Serve as the main point of contact for Loop Health members for all claims related inquiries.
- Guiding Loop Members for cashless and reimbursement process, quickly supporting them with all required information and helping them get their claim processed on time
- Build relationships and familiarity with all TPAs and insurers to improve TATs and approval time
- Serve as a POC of contact for any claims status, deductions, pre approvals etc.
- Escalate issues in claims to TPA, conduct a root-cause analysis, and share with the client.
- Coordinate with hospitals for resolution of claims issues.
- Maintain a clean and useful claims tracker.
- Flexible with rotating night shifts
- Assist claims support team with any clarification needed
What you will do
- 2+ years total work experience in health insurance claims at a broker or TPA
- Patient-facing experience is preferred either at a clinic, medical tourism, hospital IPD department or Insurer/TPA claims team -Some fluency with technology
- Willingness to travel to occasionally travel to client sites (conveyance is paid by company)
- Strong understanding of the insurance and claims process.
- Good understanding of policy wordings and keen eye for overturning deductions or denials
- Education: Doctor (MBBS/ BHMS / BAMS / BDS)Strong oral and written communication skills
- Fluency in English, Marathi, and Hindi
- Passion to improve the Indian healthcare system
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