Health Claim Associate

Protiviti India; Bengaluru; On-site; INR 250,000 - 450,000; Full time

Job summary

Protiviti India in Bangalore is seeking a Health Claims Associate to support outpatient and inpatient medical claims processing and settlement under policy terms. The role is a 9-month contract and requires accurate claims assessment within defined authority and TATs, plus handling customer queries and internal coordination.

Candidates should have 1–2 years of relevant insurance claims experience, with readiness for rotating shifts and a work-from-office setup.

Qualifications

• Experience in Health Insurance / Medical Claims is preferred.
• Experience handling outpatient and inpatient medical claims is preferred.
• Relevant insurance claims experience with 1–2 years is desirable.
• Candidates with an educational background in any discipline can be considered.

Responsibilities

• Assess, process and settle outpatient and inpatient medical insurance claims.
• Handle customer queries and resolve routine issues.
• Investigate and escalate technical claim issues when required.
• Support internal stakeholders and ensure adherence to policy terms and guidelines.

Skills

Strong verbal and written

Interpersonal and customer-service

Analytical and problem-solving

Attention to detail

Organizational skills

Multitasking

Structured and methodical

Team-player

Rapport building

Flexibility to work in shifts

Tools

AS400

Salesforce

Microsoft Office

Job description

Role: Health Claims Associate

Location: Bangalore
Contract Duration: 9 Months
Experience: Minimum 1 to 2 Years
Department: Health Insurance Claims / Claims Operations
Work from Office
Rotational Shifts (Flexible to work in shifts)
Candidates with an educational background in any discipline can be considered, provided they have relevant insurance claims experience.

Job Summary

The Health Claims Associate will be responsible for the assessment, processing and settlement of outpatient and inpatient medical insurance claims in accordance with policy contracts, terms, conditions and guidelines. The role requires accurate claims assessment within defined authority limits and agreed TATs, handling customer queries, investigating and escalating technical claim issues, and supporting internal stakeholders.

Functional Requirements

• Experience in Health Insurance / Medical Claims is strongly preferred.
• Experience handling Outpatient and Inpatient medical claims is preferred.
• Knowledge of AS400 and Salesforce would be an advantage.
• Proficiency in Microsoft Office applications.

Desired Skills

• Strong verbal and written communication skills.
• Strong interpersonal and customer-service skills.
• Analytical and problem-solving abilities.
• Ability to work independently and learn processes/systems quickly.
• Ability to multitask and work under pressure.
• Strong attention to detail and organizational skills.
• Structured and methodical approach to work.
• Strong customer orientation and team-player attitude.
• Ability to build rapport with a wide range of people.
• Flexibility to work in shifts.