Senior Executive

Medi Assist; Mumbai; On-site; INR 300,000 - 450,000; Full time

Job summary

Medi Assist in Mumbai is seeking a customer support specialist to handle employee and corporate queries related to cashless claim settlement and documentation, ensuring timely, clear communication.

You will coordinate with stakeholders, explain claim decisions, escalate where needed and maintain weekly reports on claims and TATs. This role requires client management experience and familiarity with TPA processes.

Qualifications

• Client management background preferred
• TPA experience preferred

Responsibilities

• Respond to employee/corporate queries via e-mail/phone in a timely and professional manner
• Coordinate with stakeholders for cashless claim settlement and resolution
• Explain claim decisions, deductions and provide status updates clearly to customers and agents
• Escalate unresolved issues following escalation matrix to achieve quicker resolutions
• Receive and verify completeness of claim documents; advise on pending/missing documents
• Coordinate with inward team for claim registration and ensure proper documentation flow
• Allocate claims to processing team for timely action
• Liaise with enrollment team to ensure policy registration for 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

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.