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Plum - Assistant Manager- Cashless Claims

3.00 to 5.00 Years   Bengaluru/ Bangalore (Karnataka)   21 Nov, 2024
plum
Job LocationBengaluru/ Bangalore (Karnataka)
EducationAny Graduate
SalaryAs per Industry Standards
IndustryFinancial Services/Stockbroking, Banking
Functional AreaBanks/Insurance/Financial Services
EmploymentTypeFull-time

Job Description

Assistant Manager - Cashless ClaimsLocation: BengaluruDepartment: Customer Success 7. Customer SuccessEmployment Type: Full TimeWork Arrangement: On-siteAbout PlumPlum is an employee insurance and health benefits platform focused on making health insurance simple, accessible, and inclusive for modern organizations.Healthcare in India is seeing a phenomenal shift with inflation in healthcare costs 3x that of general inflation. A majority of Indians are unable to afford health insurance on their own; and so as many as 600mn Indians will likely have to depend on employer-sponsored insurance.Plum is on a mission to provide the highest quality insurance and healthcare to 10 million lives by FY2030, through companies that care. Plum is backed by Tiger Global and Peak XV Partners.Job Purpose

  • The Assistant Manager will be responsible for processing and managing cashless insurance claims efficiently and accurately, ensuring timely closure to policyholders and seamless coordination with insurance providers.
  • Drive continuous improvement in claims processing procedures and provide guidance and support to team members to deliver exceptional customer service and achieve departmental targets.
Principal Accountabilities
  • Overseeing the end-to-end processing of cashless insurance claims, ensuring adherence to company policies and Terms & Conditions of the policy.
  • Managing a team of claims processors, providing guidance, training, and performance feedback to optimize team performance.
  • Monitoring claim processing metrics and identifying areas for improvement to enhance efficiency and accuracy.
  • Collaborating with internal & external stakeholders, such as the Onboarding team, Endorsements team, Account Management team, Hospitals, Insurers, etc., to resolve complex claims issues and ensure a seamless claims experience for employees.
  • Conducting regular performance reviews and implementing strategies to drive team productivity and meet departmental targets.
  • Keeping abreast of industry trends and best practices in claims processing to recommend process enhancements and drive continuous improvement initiatives.
  • Serving as a point of escalation for escalated claims issues and providing timely resolutions to maintain customer satisfaction.
  • Managing VIP claims (claims of founder, leadership teams, any priority customer) individually and ensure a green channel processing.
  • Participating in cross-functional projects and initiatives to support the overall strategic goals of the claims department and the organization.
Requirements
  • At least 3-5 years of experience in health insurance claims management, with a focus on cashless claims processing.
  • Prior experience working in hospitals or healthcare settings, especially in roles related to patient services, billing, or insurance coordination.
  • Experience in voice profile / Direct customer management.
  • Excellent verbal and written communication skills for effective interaction.

Keyskills :
cashless claims processing team management skillscustomer service excellence process improvement expertise communication skillsinsurance health insurance insurance claims claims management

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