PRINCIPAL ACCOUNTABILITIES:-
- Overseeing the end-to-end processing of cashless insurance claims, ensuring adherence to company policies and Terms & conditions of the policy.
- Managing a team of claims processors, providing guidance, training, and performance feedback to optimize team performance.
- Monitoring claim processing metrics and identifying areas for improvement to enhance efficiency and accuracy.
- Collaborating with internal & external stakeholders, such as Onboarding team, Endorsements team Account management team, Hospitals, Insurer’s etc to resolve complex claims issues and ensure a seamless claims experience for employees.
- Conducting regular performance reviews and implementing strategies to drive team productivity and meet departmental targets.
- Keeping abreast of industry trends and best practices in claims processing to recommend process enhancements and drive continuous improvement initiatives.
- Serving as a point of escalation for escalated claims issues and providing timely resolutions to maintain customer satisfaction.
- Manage VIP claims (claims of founder, leadership teams, any priority customer) individually and ensure a green channel processing.
- Participating in cross-functional projects and initiatives to support the overall strategic goals of the claims department and the organization.
Requirements:-
- At least 3-5 years of experience in health insurance claims management, with a focus on cashless claims processing
- Prior experience working in hospitals or healthcare settings, especially in roles related to patient services, billing, or insurance coordination
- Experience in voice profile /Direct customer management
- Excellent verbal and written communication skills for effective interaction.
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Plum is a talent assessment platform that strips away bias and reveals human potential to revolutionize how global enterprises hire, grow, and retain talent. With unmatched scalability, Plum powers more objective and equitable talent decisions across the employee lifecycle using the predictive power of psychometric data. With Plum, you can: • Quantify job fit to match the right people to the right roles • Spot potential to objectively identify and start developing future leaders sooner • Grow your people by empowering them with personalized career insights • Work better together by equipping leaders with insights to build high-performing teams Plum data is 4X more predictive of future job success than what you’ll find on a resume, so you can finally look beyond credentials, degrees, and past job titles to discover what candidates and employees are truly capable of achieving if given the opportunity. That means you can build a more diverse talent pipeline by surfacing people for opportunities based on raw talent and potential, regardless of race, gender, or background.
