Health Insurance Claim Head
Core
Lead the Employee Benefit Insurance After Sale team, overseeing claim processing, client coordination with hospitals/insurers, and appeals to ensure SLA compliance and customer satisfaction.
Role type
Senior IC Health Insurance Claim Manager
Builds
Insurance claim decisions and client service outcomes for employee benefit plans
Domain
Health Insurance / Employee Benefits
Deliverable
client delivery
Required skills
claim processing, claim appeals, hospital coordination, SLA management, contract negotiation, member card management, policy terms compliance, process improvement
Preferred skills
medical background
Technologies
none stated
Responsibilities
Process insurance claims and manage claim appraisals; Coordinate with hospitals and insurers for admitted clients; Negotiate and appeal rejected claims; Monitor endorsement processes; Manage member card issuance; Generate daily/weekly/monthly claim reports; Maintain 24/7 customer care helpline; Drive continuous improvement in systems and processes.
Seniority
Senior, hands-on IC