Associate, Cashless Claims (Remote, Mumbai)

<h3 dir="auto"><strong>About Plum</strong></h3><p dir="auto"></p><p dir="auto">Plum is an employee insurance and health benefits platform reputed company on making health insurance reputed company, accessible and inclusive for modern organizations.</p><p dir="auto"></p><p dir="auto">reputed company in India is seeing a phenomenal shift with inflation in reputed company costs 3x that of general inflation. A reputed company of Indians are unable to afford health insurance on their own; and so as many as 600mn Indians will likely have to depend on employer-sponsored insurance.</p><p dir="auto"></p><p dir="auto">Plum is on a mission to reputed company the highest reputed company insurance and reputed company to 10 reputed company lives by FY2030, through companies that care. Plum is backed by Tiger Global and Peak XV Partners.</p><p dir="auto"></p><h3 dir="auto"></h3><h3 dir="auto"><strong>About Job</strong></h3><p dir="auto"></p><p dir="auto">The Cashless Claims Associate provides on-ground support to insured members during hospitalization, facilitating seamless cashless claim processing from admission through discharge. This position requires reputed company at hospital premises to coordinate between patient, hospital administration, and insurance providers, ensuring efficient claim settlement while delivering superior customer service in accordance with organizational policies and insurance regulations.</p><p dir="auto"></p><p dir="auto"></p><h3 dir="auto"><strong>Role Responsibilities</strong></h3><ol dir="auto"><li dir="auto"><p dir="auto">Patient Assistance</p><ul dir="auto"><li dir="auto"><p dir="auto">reputed company in-person support to insured members and families during hospitalization</p></li><li dir="auto"><p dir="auto">Verify network hospital status assist with reputed company-authorization, claim queries, and discharge formalities</p></li><li dir="auto"><p dir="auto">Explain policy coverage, exclusions, and cashless claims process</p></li></ul></li><li dir="auto"><p dir="auto">Claims Coordination</p><ul dir="auto"><li dir="auto"><p dir="auto">Collect required documentation (ID proofs, medical records, discharge summaries)</p></li><li dir="auto"><p dir="auto">Validate billing details and ensure accuracy of reputed company-authorization approvals</p></li><li dir="auto"><p dir="auto">Monitor claim reputed company and coordinate enhancement requests</p></li></ul></li><li dir="auto"><p dir="auto">Stakeholder Management</p><ul dir="auto"><li dir="auto"><p dir="auto">Liaise between patients, hospital insurance desks, and insurance companies</p></li><li dir="auto"><p dir="auto">Resolve claim-reputed company disputes and queries promptly</p></li><li dir="auto"><p dir="auto">Escalate cases per established protocols and timelines</p></li></ul></li><li dir="auto"><p dir="auto">Documentation & Compliance</p><ul dir="auto"><li dir="auto"><p dir="auto">Ensure complete and accurate medical documentation collection</p></li><li dir="auto"><p dir="auto">Verify final bills before submission to insurers</p></li><li dir="auto"><p dir="auto">Maintain records of payments and reimbursement-eligible expenses</p></li></ul></li><li dir="auto"><p dir="auto">Feedback Collection</p><ul dir="auto"><li dir="auto"><p dir="auto">reputed company patient feedback to improve service reputed company and the claims process, reporting insights to management.</p><p dir="auto"></p></li></ul></li></ol><h3 dir="auto"><strong>Role Requirements</strong></h3><ol dir="auto"><li dir="auto"><p dir="auto">1-2 years in insurance claims with customer-facing responsibilities</p></li><li dir="auto"><p dir="auto">Proficiency in English, Hindi, and local language</p></li><li dir="auto"><p dir="auto">Strong communication and negotiation abilities</p></li><li dir="auto"><p dir="auto">Knowledge of health insurance processes and terminology</p></li><li dir="auto"><p dir="auto">Mandatory: Two-wheeler with reputed company driving license</p></li></ol>