22/04 Arpana
Recruiter at Sapwood Ventures

Views:149 Applications:2 Rec. Actions:Recruiter Actions:0

Senior Claims Specialist - Insurance - MBBS/BAMS/BHMS (3-5 yrs)

Pune Job Code: 14276

We are hiring a Senior 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.

Job Description :

- Serve as main point of contact for all claims related inquiries.

- Guiding members for cashless and reimbursement process, quickly supporting them with all required information.

- Build relationships and familiarity with all TPAs and insurers to improve TATs and approval time.

- Connect users with our Medical Team and doctors in case of any health queries.

- 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.

Requirements :

- 3-4 years total work experience in health insurance claims at a broker or TPA

- Highly analytical and detail-oriented

- Willingness to travel to occasionally travel to client sites (conveyance is paid by company)


- Strong oral and written communication skills

- Expert user in MS Office (Excel, Word) and highly fluent with technology

- Fluency in English, Marathi, and Hindi

- Passion to improve the Indian healthcare system

- We are building a diverse and energetic team determined to improve Indian health care. To do this, we need a team with diverse backgrounds in insurance, healthcare, technology, and operations.

- We offer comprehensive medical benefits, generous paid-time off, company social events, wellness programs, and opportunities for mentorship.

Job Type : Full-time

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