About the role:
We are looking for a Dedicated Claims Specialist with a strong background in medical and health insurance, particularly in group medical corporate policies. The ideal candidate should have 2-4 years of experience in claims processing or CRM roles.
Key Responsibilities:
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Handle end-to-end processing of reimbursement claims for group medical corporate policies.
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Provide excellent customer service by addressing claims-related queries via Freshchat, Ozontel, and Freshdesk.
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Analyze medical documentation, policy terms, and conditions to ensure accurate claim assessment and processing.
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Liaise with internal teams, insurers, TPA’s, and hospitals to ensure seamless claims settlement and timely resolutions.
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Manage claims escalations, ensuring prompt resolution while maintaining a customer-centric approach.
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In-depth knowledge of corporate group medical insurance policies and claims processing.
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Ability to understand medical terminology, treatment procedures, and health-related documentation.
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Proficient in Ozontel, Freshdesk, or similar customer support and claims management tools.
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Strong communication and problem-solving skills to manage customer relationships and resolve issues effectively.
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Attention to detail to ensure accuracy in claim processing and documentation review.
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Ability to collaborate effectively with cross-functional teams, including insurance partners and hospital networks.
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Bachelor’s degree in healthcare, insurance, or related field preferred.
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2-4 years of experience in claims processing, CRM role preferably within group medical corporate policies.
