Reliance Health aims to redefine healthcare accessibility, affordability, and delightfulness in Emerging Markets. Leveraging technology, we've built an integrated health system comprising affordable health insurance, telemedicine services, and a network of partner and proprietary healthcare facilities. This enables us to offer innovative healthcare solutions precisely when our users need them the most.
The Claims Operations Associate is responsible for managing claims and approvals processes, and the scope of work includes vetting health insurance claims and approval from service providers, reconciling payments and negotiating and uploading claim tariffs.
Key Responsibilities
- Examine and approve or reject healthcare providers’ claims to meet set targets.
- Investigate claims for fraud, waste, and abuse.
- Promptly resolve escalated approval requests for care.
- Negotiate tariffs and update the providers’ dashboard and execute other elements of tariff management.
- Collaborate with the technology team to improve the processes claims, tariff and approvals management system.
- Collaborate with customer success and provider relations teams to ensure customer satisfaction goals.
Requirements
- Minimum of a first degree in medicine, nursing or pharmacy and completion of internship or houseman ship.
- Previous experience in a claim examiner role is a major advantage.
- Excellent numeracy, analytical and problem-solving skills.
- A high-level of responsiveness is essential and openness to working shifts including occasional weekends.
- Strong medical and clinical knowledge and experience.
- Excellent interpersonal and communication skills.
- Renumeration: 250k - 300k
Benefits
At Reliance Health, we prioritize our people and their well-being. Our benefits package is designed to support your success, growth, and happiness. Here’s what you’ll enjoy:
- Hybrid, Flexible Environment
Experience the best of both worlds with our hybrid setup—work from home when you need focus, and connect with a vibrant, collaborative team in the office. - Competitive Salary and Benefits
We offer a salary that’s benchmarked against the best in the industry, ensuring your expertise and impact are fully rewarded. - Premium Health Insurance
Comprehensive health coverage for you and your family, because your well-being comes first. - Unlimited Leave
Take the time you need when you need it—no limits, no questions. - Meaningful Impact
Play a key role in transforming customer experiences and shaping healthcare innovation. - Collaborative Work Culture
Join a supportive, inclusive, and team-focused environment that celebrates diversity. - Growth Opportunities
Access tools, mentorship, and resources to elevate your skills and career. - Learning & Development Allowance
We provide an allowance to support your ongoing professional growth and skill enhancement. - This is more than a job—it's a chance to grow, thrive, and make a real difference. At Reliance Health, your journey matters.
Top Skills
What We Do
We use technology to make quality healthcare delightful, affordable, and accessible in emerging markets.
Since 2016, we have worked to combine the power of technology and data with the passion and dedication of a talented group of people devoted to providing great quality healthcare to regions that have typically been overlooked.
We do this by building an integrated healthcare system where we receive easy install mental payments from individuals and businesses and provide them healthcare through a combination of platforms, services and a fleet of modern clinics we operate alongside other third-party clinical partners.
