Job Description

About Plum
Plum 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.
About Job
The Cashless Claims Associate provides on-ground support to insured members during hospitalization, facilitating seamless cashless claim processing from admission through discharge. This position requires presence at hospital premises to coordinate between patient, hospital administration, and insurance providers, ensuring efficient claim settlement while delivering superior customer service in accordance with organizational policies and insurance regulations.
Role Responsibilities
Patient Assistance
Provide in-person support to insured members and families during hospitalization
Verify network hospital status assist with pre-authorization, claim queries, and discharge formalities
Explain policy coverage, exclusions, and cashless claims process
Claims Coordination
Collect required documentation (ID proofs, medical records, discharge summaries)
Validate billing details and ensure accuracy of pre-authorization approvals
Monitor claim progress and coordinate enhancement requests
Stakeholder Management
Liaise between patients, hospital insurance desks, and insurance companies
Resolve claim-related disputes and queries promptly
Escalate cases per established protocols and timelines
Documentation & Compliance
Ensure complete and accurate medical documentation collection
Verify final bills before submission to insurers
Maintain records of payments and reimbursement-eligible expenses
Feedback Collection
Gather patient feedback to improve service quality and the claims process, reporting insights to management.
Role Requirements
1-2 years in insurance claims with customer-facing responsibilities
Proficiency in English, Hindi, and local language
Strong communication and negotiation abilities
Knowledge of health insurance processes and terminology
Mandatory: Two-wheeler with valid driving license

Skills Required