#LMRP0007Job Role: Claims Executive
Industry: TPA Health Insurance
Location: Chennai
Experience: 2 -5 years
Qualification: Bachelors Degree
Salary: 3LPA - 3.6LPA
Roles & Responsibilities
Accurate and efficient processing of claims, including verifying policy coverage, assessing claim validity, and calculating the appropriate payable amount.
Get fully trained in claims software and complete understanding of features and validations in the system
Get good understanding of process flow, movement of claim and stakeholders expectations w r t claims services
Accurate data entry of bills into appropriate columns/fields
Verify the accuracy of details entered at inward level and correcting wherever required.
Adhere to SoPs defined
Processing the number of claims allocated. Prioritizing claims as required.
Be aware of all insurers SoPs and application of relevant protocols.
Be updated about the new products and features in health policies
Interaction with customer service team and help with any clarifications in billing
Ensure clarity in communication to customers.
Identify and report potential fraudulent claims, following established procedures and guidelines.
Coordinate with doctors and CRMs to aid in assessing claims accurately.
Maintain daily report of claims processed and report to team lead.
Actively participate in training sessions and workshops to enhance knowledge of insurance products, claims processing techniques, and industry developments.
Assist medical officers in responding to audit queries of insurers.Job Type: Full-timePay: \xe2\x82\xb9300,000.00 - \xe2\x82\xb9360,000.00 per yearBenefits:

• Cell phone reimbursement
• Commuter assistance
• Paid sick time
• Paid time off
• Provident Fund

Schedule:

• Day shift

Experience:

• total work: 2 years (Required)

Work Location: In person