Insurance Claims Specialist

Job Title: Insurance Claim Specialist Location: Bangalore Experience: 1–3 Years Looking for Immediate Joinee Job Summary: The Insurance Claim Specialist will be responsible for managing end-to-end cashless insurance claim processes while ensuring effective patient handling and counseling. The role focuses on delivering a smooth, transparent, and stress-free experience for patients during hospitalization and discharge. Key Responsibilities:Handle end-to-end cashless insurance claim processing , including pre-authorization, approvals, and final settlements Coordinate with insurance companies and TPAs for claim submissions, approvals, query resolution, and follow-ups Manage patient and attendant interactions , explaining procedures, documentation, and claim status clearly Counsel patients on insurance coverage, co-payments, deductions, exclusions, and policy limitations Resolve queries raised by insurers/TPAs promptly to avoid delays or claim rejections Track and monitor claim status to ensure timely closure Verify insurance eligibility, policy details, and coverage before admission/treatment Coordinate with internal teams such as billing, front office, and medical records Maintain accurate documentation and claim records Ensure compliance with insurance guidelines and hospital policies Assist patients during discharge process by coordinating final approvals and settlements Prepare MIS reports and support audits when required Required Skills & Competencies:Strong knowledge of cashless health insurance claim processes Excellent patient handling and counseling skills Experience working with insurance companies and TPAs Strong communication skills (verbal & written) Ability to multitask and work under pressure High attention to detail and documentation accuracy Qualifications: Any Graduate (preferred) Diploma/Certification in Medical Billing / Healthcare Management / Insurance is an added advantage Grooming & Professional Conduct:Maintain a neat, clean, and professional appearance at all times Adhere to formal dress code and grooming standards Demonstrate professional etiquette, empathy, and courtesy in all interactions with patients and insurers