Mediacal Billing -Executive/Senior Executive-CRM

Medi Assist; Bengaluru; On-site; INR 360,000 - 480,000; Full time

Job summary

Medi Assist in Bengaluru (India) is hiring for JD Account Management- Executive/Senior Executive to handle end-to-end claim processing for corporate clients.

You will receive, verify, and track documents, ensure SLA/TAT, respond to queries, and generate weekly reports. This role involves coordinating with internal teams to enable cashless and reimbursement settlements.

Qualifications

• Experience in claims processing and customer support.
• Familiar with healthcare claims workflows (cashless/reimbursement).
• Strong communication and documentation skills.

Responsibilities

• Receive and verify claim documents for completeness and inform employees.
• Track documents to meet SLA/TAT for claims and cards.
• Coordinate with inward team for claim receiving and registration.
• Liaise with enrolment team to register policy for cashless and reimbursement.
• Respond to employee and agent queries via email/phone.
• Maintain weekly reports on claims, queries and TAT.
• Escalate issues per escalation matrix.
• Provide timely claim status and explanations to customers.

Skills

Customer service

Documentation

SLA adherence

Query resolution

Job description

JD Account Management- Executive/Senior Executive

Job Responsibilities

• Receive and check claim documents for completeness and advice employees
• regarding pending documents, if any.
• Track and control documents to ensure TAT of claims/cards as per SLA.
• Feedback from Insurers and Corporates.
• Additional revenue opportunities from existing Corporates.
• Respond to queries from the employees of the corporate through e-mails.
• Maintain weekly reports on claims and queries and the TAT of the same
• Escalate issues as per the escalation matrix.
• To attend to any other assignments assigned to you from time to time.
• Respond to queries from the employees of the corporate over Phone
• Maintain weekly reports on claims and queries and the TAT of the same
• Escalate issues as per the escalation matrix.
• To attend to any other assignments assigned to you from time to time.

Transactional Activities

• To coordinate with inward team for claim receiving and claim registration
• Allocating new generated claims to processing team for action
• Liasoning with enrolment team to register the policy for cashless and reimbursement
• Coordination with regional agents, customers for claim related queries, settlement
• queries- cashless /reimbursement
• Answering incoming calls of all customers / agents / internal team
• Keep track of all customer queries with claim numbers and follow-up to verify that
• all queries are resolved.
• Coordinating with cashless / pre auth team to ensure cashless is granted within
• TAT and to provide timely claim status. Query letter / Settlement letter should be
• explained properly to customers / agents on queries and deductions.