1. Health Claims Associate

Principal Accountabilities and Responsibilities (e.g., for Business, Customers and Stakeholders; internal control environment, etc.)

- Conduct In-depth assessment of Outpatient (70%, TAT 14 days) & In-patient Medical (30%, TAT – 21 days) claims in accordance with policy contract and guidelines

- Ensuring emails and telephone call inquiries are well-managed and responded in a timely manner

- Ensuring the claim is assessed correctly in accordance with policy contracts and guidelines and approved within the Authority Limit given.

- Ensuring claim settlement is concluded within the agreed Turnaround Time (TAT)

- Investigate and escalate technical claim issues as and when experienced"

Leadership and Teamwork

- Continuous communication with both internal and external customers and providing the required support with the objective of providing quality claim service experience

- Assist in providing necessary information and ad-hoc assignments to Senior Manager / Manager to allow for accurate and timely submission of reports to management.





Functional Knowledge

- A recognized Diploma or Degree in any discipline

- Minimum of 1 – 2 years of related work experience in the insurance industry, preferably experience with handling Outpatient and inpatient health claims

- Knowledge of AS400 and Salesforce an advantage

- Proficient in Microsoft Office application.

Others

- Excellent verbal and written communication skills and interpersonal skills

- Able to work independently and a fast learner, able to grasp processes and systems quickly

- Able to multi-task and work under pressure to meet tight deadlines in a fast-paced environment

- Strong customer orientation, team player

- Flexibility to work shifts.

- Ability to build rapport with and relate to a wide range of people.

- Robust analytical and problem-solving skills along with being organized, and structured. methodological and assertive.

- Strong interpersonal and customer servicing skills.

📌 Health Claims Associate - 12 months Contract (Bengaluru)
🏢 protiviti india
📍 Bengaluru