Founder at Sportism
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Sportism - Senior Claims Specialist - MBBS/BAMS/BDS/BHMS (2-3 yrs)
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.
- Serve as main point of contact for Organization's Health members for all claims related inquiries.
- Guiding Organization's 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+ 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 -Some fluency with techmology
- Highly analytical and detail-oriented
- Willingness to travel to occasionally travel to client sites (conveyance is paid by company)
Education:
- Doctor (MBBS/ BHMS / BAMS / BDS)
- 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
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