The Role
Own the end-to-end employee claims experience, including communication, documentation verification, claim tracking, form assistance, insurer and TPA coordination, escalation resolution, and timely reimbursement settlement. The role also translates insurance queries, gathers feedback to identify process improvements, and ensures accurate, timely claim resolution while supporting employees with empathy and clear communication.
Summary Generated by Built In
The Role
As a Claims Associate, you'll own the end-to-end claims experience for our clients' employees - from the first query to final resolution. You'll be the primary point of contact between employees, insurers, and TPAs, making sure claims move quickly, documentation is accurate, and escalations are resolved before they become churn risks.
What You'll Own
- Communicate with employees on claim status, process, and requirements.
- Explain the claims process clearly, over email, call, and in conversation.
- Follow up on and verify claim documentation for completeness and accuracy.
- Assist employees in filling out claim forms correctly the first time.
- Track claim status end-to-end and proactively update employees.
- Coordinate with TPAs/insurers to push claims through and resolve queries.
- Translate insurer/TPA queries into plain language for employees, and guide them on how to respond.
- Manage and resolve claims-related escalations.
- Collect claim feedback to identify process gaps.
- Ensure on-time settlement of reimbursement claims.
What We're Looking For
- 3-10 years of experience in a claims role, ideally with a broking firm, TPA, or insurer.
- Strong oral and written communication skills, with the ability to explain claims processes clearly and effectively.
- Strong working knowledge of group health insurance, including GMC policy terms and conditions.
- End-to-end knowledge of processing both cashless and reimbursement claims.
- Good understanding of how TPAs and insurance companies operate, including claims coordination and query resolution.
- Empathy and patience when handling employee queries, concerns, and escalations, with the ability to work effectively in a fast-paced, multitasking environment.
- Good Excel skills and strong attention to detail are a plus.
Why This Role
- Own the end-to-end claims experience for our clients' employees.
- Work directly with employees, insurers, and TPAs to drive timely claim resolution.
- Play a key role in resolving escalations and ensuring a smooth employee experience.
- Identify process gaps through claim feedback and contribute to improving the claims experience.
Skills Required
- 3-10 years of experience in a claims role, ideally with a broking firm, TPA, or insurer
- Strong oral and written communication skills
- Ability to explain claims processes clearly and effectively
- Strong working knowledge of group health insurance, including GMC policy terms and conditions
- End-to-end knowledge of processing cashless and reimbursement claims
- Understanding of TPA and insurance company operations, claims coordination, and query resolution
- Empathy and patience when handling employee queries, concerns, and escalations
- Ability to work effectively in a fast-paced, multitasking environment
- Good Excel skills
- Strong attention to detail
Am I A Good Fit?
Get Personalized Job Insights.
Our AI-powered fit analysis compares your resume with a job listing so you know if your skills & experience align.
Success! Refresh the page to see how your skills align with this role.
The Company
What We Do
Nova Benefits is an India-based B2B insurance broker and employee benefits platform building an employee health and wellness solution for businesses. The company partners with employers to provide teams access to high-quality healthcare, using technology to deliver benefits at scale. Its platform supports insurance and wellness programs while reducing HR administration, and serves more than 500 corporate clients across India.
.jpg)
