CRM- Executive/ Senior Executive

Medi Assist; Mumbai; On-site; INR 400,000 - 560,000; Full time

Job summary

Medi Assist in Mumbai is seeking a Customer Claims Associate to handle employee and corporate queries via email and phone, coordinate cashless claim settlements, and clearly explain decisions to customers and agents.

You will verify documents, escalate issues, coordinate with inward and enrollment teams, and maintain weekly reports on claims and response times.

Qualifications

• Experience in client management and TPA processes.
• Excellent written and verbal communication.
• Ability to handle claims processes and documentation.

Responsibilities

• Respond to employee/corporate customer queries via e-mail/ phone in a timely and professional manner.
• Coordinate with respective stake holders for cashless claim settlement and resolution.
• Explain claim decisions, deductions and provide status updates clearly to customers and agents.
• Escalate unresolved issues following the defined escalation matrix to get quicker resolutions & communicate the same to the customers.
• Receive and verify the completeness of claim documents; advise on any pending or missing documents.
• Coordinate with the inward team for claim registration and ensure proper documentation flow.
• Allocate claims to the processing team for timely action.
• Liaise with the enrollment team to ensure policy registration for both cashless and reimbursement claims.
• Monitor and follow up on all queries using claim numbers until full resolution.
• Maintain weekly reports detailing claims, queries, and their respective TATs

Skills

Client management

TPA experience

Job description

Role & responsibilities

Respond to employee/corporate customer queries via e-mail/ phone in a timely and professional manner

Coordinate with respective stake holders for cashless claim settlement and resolution

Explain claim decisions, deductions and provide status updates clearly to customers and agents.

Escalate unresolved issues following the defined escalation matrix to get quicker resolutions & communicate the same to the customers.

Receive and verify the completeness of claim documents; advise on any pending or missing documents.

Coordinate with the inward team for claim registration and ensure proper documentation flow

Allocate claims to the processing team for timely action.

Liaise with the enrollment team to ensure policy registration for both cashless and reimbursement claims.

Allocate claims to the processing team for timely action.

Liaise with the enrollment team to ensure policy registration for both cashless and reimbursement claims.

Monitor and follow up on all queries using claim numbers until full resolution.

Maintain weekly reports detailing claims, queries, and their respective TATs

Preferred candidate profile

Candidates with Client management background and TPA experience will be preferred.