Plum is an employee insurance and health benefits platform focused on making
health insurance simple, accessible and inclusive for modern organizations.
Healthcare in India is seeing a phenomenal shift with inflation in healthcare
costs 3x that of general inflation. A majority of Indians are unable to afford
health insurance on their own; and so as many as 600mn Indians will likely have
to depend on employer-sponsored insurance.
Plum is on a mission to provide the highest quality insurance and healthcare to
10 million lives by FY2030, through companies that care. Plum is backed by Tiger
Global and Peak XV Partners.
ABOUT JOB
The Cashless Claims Navigator provides on-ground support to insured members
during hospitalization, facilitating seamless cashless claim processing from
admission through discharge. This position requires presence at hospital
premises to coordinate between patient, hospital administration, and insurance
providers, ensuring productive claim settlement while delivering superior
customer service in accordance with organizational policies and insurance
regulations.
ROLE RESPONSIBILITIES
1. Patient Assistance
* Provide in-person support to insured members and families during
hospitalization
* Verify network hospital status assist with pre-authorization, claim
queries, and discharge formalities
* Explain policy coverage, exclusions, and cashless claims process
2. Claims Coordination
* Collect required documentation (ID proofs, medical records, discharge
summaries)
* Validate billing details and ensure accuracy of pre-authorization
approvals
* Monitor claim progress and coordinate enhancement requests
3. Stakeholder Management
* Liaise between patients, hospital insurance desks, and insurance companies
* Resolve claim-related disputes and queries promptly
* Escalate cases per established protocols and timelines
4. Documentation & Compliance
* Ensure complete and accurate medical documentation collection