Associate, Cashless Claims (Remote, Hyderabad) at Plum Benefits Private Limited

Bengaluru, karnataka, India -

Full Time

Start Date

Immediate

Expiry Date

06 Jun, 26

Salary

0.0

Posted On

08 Mar, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Customer Service, Claims Processing, Coordination, Documentation, Compliance, Negotiation, Communication, Policy Coverage, Pre-authorization, Billing Validation, Dispute Resolution

Industry

Insurance

Description

ABOUT PLUM Plum is an employee insurance and health benefits platform focused on making health insurance simple, accessible and inclusive for modern organizations. Healthcare in India is seeing a phenomenal shift with inflation in healthcare costs 3x that of general inflation. A majority of Indians are unable to afford health insurance on their own; and so as many as 600mn Indians will likely have to depend on employer-sponsored insurance. Plum is on a mission to provide the highest quality insurance and healthcare to 10 million lives by FY2030, through companies that care. Plum is backed by Tiger Global and Peak XV Partners. ABOUT JOB The Cashless Claims Associate provides on-ground support to insured members during hospitalization, facilitating seamless cashless claim processing from admission through discharge. This position requires presence at hospital premises to coordinate between patient, hospital administration, and insurance providers, ensuring efficient claim settlement while delivering superior customer service in accordance with organizational policies and insurance regulations. ROLE RESPONSIBILITIES 1. Patient Assistance * Provide in-person support to insured members and families during hospitalization * Verify network hospital status assist with pre-authorization, claim queries, and discharge formalities * Explain policy coverage, exclusions, and cashless claims process 2. Claims Coordination * Collect required documentation (ID proofs, medical records, discharge summaries) * Validate billing details and ensure accuracy of pre-authorization approvals * Monitor claim progress and coordinate enhancement requests 3. Stakeholder Management * Liaise between patients, hospital insurance desks, and insurance companies * Resolve claim-related disputes and queries promptly * Escalate cases per established protocols and timelines 4. Documentation & Compliance * Ensure complete and accurate medical documentation collection * Verify final bills before submission to insurers * Maintain records of payments and reimbursement-eligible expenses 5. Feedback Collection * Gather patient feedback to improve service quality and the claims process, reporting insights to management. ROLE REQUIREMENTS 1. 1-2 years in insurance claims with customer-facing responsibilities 2. Proficiency in English, Hindi, and local language 3. Strong communication and negotiation abilities 4. Knowledge of health insurance processes and terminology 5. Mandatory: Two-wheeler with valid driving license

Responsibilities

The Associate provides in-person support to insured members during hospitalization, verifying network status, assisting with pre-authorization, and handling discharge formalities. This role also involves collecting necessary documentation, validating billing details, and liaising between patients, hospital desks, and insurance companies to resolve claim disputes.