Role & responsibilities
- Handle day-to-day Employee Benefits claims, primarily Group Mediclaim (GMC) and Group Personal Accident (GPA).
- Coordinate with clients, employees, TPAs and insurance companies for claim processing and resolution.
- Follow up on pending claims, documents and approvals.
- Verify claim documents and ensure completeness before submission.
- Maintain claim trackers and provide regular updates to clients.
- Address employee/client queries related to claim status, documentation and settlement.
- Escalate critical or delayed claims to the appropriate stakeholders.
- Maintain proper records and MIS of claims handled.
- Ensure timely and professional client servicing.
Preferred candidate profile
- 1-2 years of experience in Employee Benefits Claims / Health Insurance Claims.
- Candidates from TPA, Insurance Broking or Insurance Company background preferred.
- Exposure to GMC/GPA claims will be an advantage.
- Good communication and coordination skills.
- Robust follow-up and problem-solving ability.
- Good knowledge of MS Excel and basic MIS reporting.
- Customer/client-service orientation is essential.