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 rapid learner, able to grasp processes and systems quickly
Able to multi-task and work under pressure to meet tight deadlines in a fast-paced workplace
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