Claims Specialist

Loop Health

Loop Health

This job is no longer accepting applications

See open jobs at Loop Health.
Pune, Maharashtra, India
Posted on Thursday, February 23, 2023

We are hiring a 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.

Roles and responsibilities

  • Serve as the main point of contact for Loop Health members for all claims related inquiries.
  • Guiding Loop Members for cashless and reimbursement process, quickly supporting them with all required information and helping them get their claim processed on time
  • Build relationships and familiarity with all TPAs and insurers to improve TATs and approval time
  • Serve as a POC of contact for any claims status, deductions, pre approvals etc.
  • 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.
  • Flexible with rotating night shifts
  • Assist claims support team with any clarification needed

What you will do

  • 2+ 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 or Insurer/TPA claims team -Some fluency with technology
  • Willingness to travel to occasionally travel to client sites (conveyance is paid by company)
  • Strong understanding of the insurance and claims process.
  • Good understanding of policy wordings and keen eye for overturning deductions or denials
  • Education: Doctor (MBBS/ BHMS / BAMS / BDS)Strong oral and written communication skills
  • Fluency in English, Marathi, and Hindi
  • Passion to improve the Indian healthcare system

This job is no longer accepting applications

See open jobs at Loop Health.