Job role- Customer Care Executive-

Key Responsibilities:
Operational / Functional
Manage high volumes of inbound and outbound calls efficiently.
Adhere to predefined communication scripts across diverse topics.
Provide accurate information to customers, hospitals, and branches regarding policy terms, member status, and claim status.
Greet and engage customers professionally using approved scripts.
Respond to telephonic and email queries promptly.
Identify customer needs, clarify information, research issues, and offer effective solutions or alternatives.
Build robust, sustainable customer relationships by delivering an exceptional experience.
Maintain accurate records of all interactions in the call center database.
Participate regularly in training programs to enhance knowledge and performance.
Meet individual and team qualitative and quantitative targets.
Escalate queries to team leaders when required.
Ensure fair treatment of customers in line with regulatory and company standards.
Handle claimrelated complaints with empathy and efficiency.




Guide customers through claims processes, including documentation requirements.
Provide explicit explanations when a claim is not covered.
Complaints Management and Grievance Redressal (20%)
Monitor and resolve regular and escalated Health Claim complaints within defined timelines.
Coordinate with relevant stakeholders for timely escalation management and query resolution.
Manage NPS (Net Promoter Score) data in collaboration with Underwriting, Operations, and IM teams to ensure data accuracy.
Drive reduction in customer complaint volumes.

Educational Qualifications
10+2, 10+3 years full time Diploma + Graduate in any discipline (graduates preferred).
Freshers may be considered if robust customer service skills are demonstrated.

Core Experience
Experience in a call center or customer service function within a TPA or an inhouse setup of a general/health insurance company.
Ex

📌 Customer Care Executive Pune
🏢 SBI General Insurance
📍 Pune