Claims Senior Executive

Greetings From Link - K Insurance TPA

We are hiring Claims Senior Executive for our claims Department at our Chennai Corporate office.

Year of Experience : 1 to 3 Years

Qualification: Any Degree

Industry: TPA \ Health Insurance (Indian Based Claims )

Roles and Responsibility

• Accurate and efficient processing of claims, including verifying policy coverage, assessing claim validity, and calculating the appropriate payable amount.
• Get fully trained in claims software and complete understanding of features and validations in the system
• Get good understanding of process flow, movement of claim and stakeholders expectations w r t claims services
• Accurate data entry of bills into appropriate columns/fields
• Verify the accuracy of details entered at inward level and correcting wherever required.
• Adhere to SoPs defined
• Processing the number of claims allocated. Prioritizing claims as required.
• Be aware of all insurers SoPs and application of relevant protocols.
• Be updated about the new products and features in health policies
• Interaction with customer service team and help with any clarifications in billing
• Ensure clarity in communication to customers.
• Identify and report potential fraudulent claims, following established procedures and guidelines.
• Coordinate with doctors and CRMs to aid in assessing claims accurately.
• Maintain daily report of claims processed and report to team lead.
• Actively participate in training sessions and workshops to enhance knowledge of insurance products, claims processing techniques, and industry developments.
• Assist medical officers in responding to audit queries of insurers.

Important Note:

• Health Insurance / TPA profile only eligible
• Interested candidate can share your updated resume to careers@linkktpa.com

Job Types: Full-time, Permanent

Pay: ₹25,000.00 - ₹30,000.00 per month

Benefits:

• Provident Fund

Experience:

• Cashless and Reimbursement: 1 year (Required)

Work Location: In person