Executive/ Sr. Executive/Asst. Manager- Claims at PlanCover.com

Gurgaon, haryana, India -

Full Time

Start Date

Immediate

Expiry Date

26 Sep, 26

Salary

0.0

Posted On

28 Jun, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Management, Health Insurance Knowledge, Customer Service, Analytical Skills, Problem Solving, Conflict Resolution, Quality Assurance, Data Privacy, Stakeholder Management, Audit and Review, Interpersonal Communication, Report Preparation

Industry

Insurance

Description

Position Overview: Will be responsible for overseeing the management and processing of health/accidental/life insurance claims. This role involves ensuring accuracy, efficiency, and adherence to established guidelines and regulations throughout the claims process. The person should work closely with the stake holders and internal teams to facilitate the smooth processing and resolution of claims. Key Responsibilities: Manage the end-to-end process of health/accidental/life insurance claims through the insurance company/TPA. Provide excellent customer service to policyholders and healthcare providers by addressing queries, concerns, and escalations related to claims. Maintain a professional and empathetic approach when handling sensitive and challenging customer interactions. Build and maintain strong relationships with insurance providers, healthcare professionals, and internal stakeholders to streamline communication and collaboration. Coordinate with these parties to resolve complex or disputed claims efficiently. In-depth knowledge of health insurance policies, claim procedures, and regulations, familiarity with policy terms. Strong analytical and problem-solving skills to assess complex claims and make accurate decisions. To manage and resolve issues or concerns that arise within the insurance policy or claims process. It involves a systematic approach to address and resolve problems, ensuring that they are effectively managed and escalated to the appropriate individuals or departments for resolution. Implement quality assurance measures to ensure the accuracy and consistency of claims processed by the insurance company/TPA . Conduct regular audits and reviews to identify areas for improvement and implement corrective actions. Ability to handle confidential information and maintain data privacy and security. Ensure proactive outreach to the clients and stakeholders. Other day-to-day operational services like work allocation, report preparation, Etc. Willingness and flexibility to take customer calls beyond office hours including week-off and holidays. Requirements Qualification and Experience: Bachelor's degree or equivalent experience in a related field. 1-3 years of experience in the Health Insurance industry or a similar customer service oriented industry. Excellent communication and interpersonal skills. Problem-solving and conflict resolution abilities. Analytical mindset with the ability to gather and interpret data. Proficiency in using relevant software applications and tools. Knowledge of health insurance processes, products, and regulations is preferred. Work from office only. Benefits About us Company Name: HII Insurance Broking Services Private Limited (PlanCover.com). PlanCover.com is a rapidly growing Insure-tech broker, focused on providing insurance solutions to small businesses ranging from technology, start-ups, consulting, and professional businesses. We partner with some of the largest insurers and TPAs. When you join PlanCover.com, you’re joining a company that values career development, collaboration, innovation, and inclusiveness. We want employees to feel proud about being part of a company that is committed to doing the right thing. You’ll have the opportunity to grow your career while developing personally and professionally through various resources and programs. Join our team and unlock the limitless potential of your career journey. We are dedicated to providing you with unparalleled opportunities for growth, mentorship from industry leaders, and impactful projects that will propel your career to new heights. PlanCover.com is a relationship-based company and appreciates how both virtual and in-person interactions support our culture. What we provide: You're joining a company that values career development, collaboration, innovation, and inclusiveness You'll have the opportunity to grow your career while developing personally and professionally through various resources and programs. Startup learning experience. Fun, collaborative environment with a flat structure. Risk and rewards compensation matching industry-best. Health and Accidential insurance coverage. Have you subscribed to our Linkedin Page (Please do) - http://bit.ly/46MzFvf

Responsibilities

Oversee the end-to-end processing of health, accidental, and life insurance claims while ensuring accuracy and regulatory compliance. Coordinate with insurance providers, TPAs, and stakeholders to resolve complex claims and provide empathetic customer support.