Cashless Claims Team Member

About the role

The Cashless Claims Team Member will coordinate with service‑provider partners to ensure timely settlement of travel and OPD claims. The role involves regular medical and technical audits of approved claims and maintaining accurate MIS and reporting.

Key responsibilities

• Prepare and submit periodic and ad‑hoc claims reports accurately and on time.
• Develop Excel shortcuts, formulas, and alternative tools to streamline reporting.
• Conduct cursory and sanity checks before report submission.
• Close audit observations and ensure compliance with SLA‑defined TAT.
• Train partner claim processors on policy terms, time management, and delegation.
• Collaborate closely with internal and external stakeholders, including data teams, to manage claim data and MIS.

Required profile

• Assistant/Deputy Manager level experience in claims or insurance operations.
• Strong coordination and proactive problem‑solving abilities.
• Excellent communication and stakeholder‑management skills.

Required skills

• Advanced Excel (shortcuts, formulas, data manipulation).

What we offer

• Opportunity to work within a leading health insurance organization.
• Exposure to large‑scale claim processing and audit functions.