Claims Executive

Year    MH, IN, India

Job Description

Location:

Powai, Mumbai (Preferred candidates from nearby)

Experience:

Minimum 2 Years

Salary:

up to 3.5 LPA

Reporting to:

Megha N Sr Claims Executive

Working Hours:

10:00 AM 6:30 PM (Two Saturdays off per month)

Employment Type:

Full time

Job Overview:

We are looking for a

diligent and detail-oriented Claims Executive

to handle

health, motor, and non-motor insurance claims

for both

corporate and retail clients

The ideal candidate should ensure

timely and accurate settlements

maintain clear communication with all stakeholders and deliver

exceptional customer service

while adhering to all regulatory and compliance guidelines.

Key Responsibilities:



Process and manage health, motor (and non-motor insurance claims). Review physical and digital claim files, verify documentation, and ensure proper file management. Coordinate with insurers,

TPAs, internal/external surveyors

for claim updates and resolutions. Respond to client queries, follow up for missing documents, and provide status updates. Ensure timely claim processing within the defined

Turnaround Time (TAT).

Review settlement letters for any

errors or unjust deductions.

Facilitate

cashless claim approvals

through coordination with hospitals and internal cashless teams. Assist clients in filing ombudsman complaints for unfairly rejected claims. Maintain digital claim records and update closure entries in

Saiba.

Support

urgent cashless claims

during weekends or off hours when required. Attend to

walk in queries

and provide personalized support to

HNI clients.


Outdoor Visits:



oVisit hospitals to support HNI clients during cashless claims.

oHandle claims processing in the absence of other team members.

oEnsure timely email responses and maintain digital records of all documents.

Qualifications



oGraduate (Preferred Insurance, Healthcare, or Business-related field).

oMinimum Experience 2 years in insurance claims processing.

oIn depth knowledge of

insurance policies, TPAs, claim life cycles,

and

regulatory compliance.



Key Skills:



oExcellent verbal and written

communication skills in English.



oHigh level of

accuracy and attention to detail.



oStrong

time management and organizational skills.



oAbility to work both

independently and in a team.



o

Customer centric

approach with a proactive problem-solving attitude.

oProficiency in using

Microsoft Office tools

(Word, Outlook).

oGood understanding of

insurance claim cycles,

documentation standards, and regulatory norms.

Compensation Benefits:



Competitive salary package in line with

market standards,

Group Medical Insurance

(GMC) coverage, Annual performance-based increment eligibility,

Application Process



Interested candidates can share their updated profiles with the subject line

"[JobTitle]Title] --[Your Name]" at proactive@smgroup work

For queries, contact

+91 8850694865



Job Types: Full-time, Permanent

Pay: ?10,041.93 - ?34,666.29 per month

Benefits:

Health insurance
Schedule:

Day shift
Supplemental Pay:

Performance bonus
Work Location: In person

Speak with the employer


+91 08850694865

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Job Detail

  • Job Id
    JD3831222
  • Industry
    Not mentioned
  • Total Positions
    1
  • Job Type:
    Full Time
  • Salary:
    Not mentioned
  • Employment Status
    Permanent
  • Job Location
    MH, IN, India
  • Education
    Not mentioned
  • Experience
    Year