Customer Service Manager

Role & responsibilities

Role Overview

The Customer Service Manager IL Sahayak is responsible for providing end-to-end cashless assistance to customers during hospitalization. The role focuses on ensuring a seamless, transparent, and hassle-free claims experience while maintaining high service standards and customer satisfaction.

Key Roles & Responsibilities

• Provide end-to-end support for cashless hospitalization cases across ICICI Lombard’s network hospitals.
• Coordinate with hospitals, internal teams, and customers to ensure timely approval and processing of claims.
• Ensure a smooth and hassle-free customer experience during the hospitalization journey.
• Conduct audit and verification of claims, including hospital documents, estimates, and bills.
• Identify discrepancies, escalate issues, and ensure compliance with policy terms and guidelines.
• Maintain regular communication with patients and their families, providing status updates and guidance.
• Collect and analyze customer feedback to improve service quality and customer satisfaction.
• Collaborate with internal stakeholders (Claims, Medical, Operations) to resolve queries and reduce TAT.
• Ensure adherence to company policies, regulatory requirements, and quality standards.

Key Skills & Competencies

• Strong knowledge of health insurance claims (cashless process preferred)
• Excellent communication and interpersonal skills
• Ability to handle customer interactions in critical situations
• Strong analytical and auditing skills
• Proven Negotiation skills
• Problem-solving mindset with attention to detail
• Ability to work under pressure and manage multiple cases simultaneously

Key Performance Indicators (KPIs)

• Customer satisfaction (CSAT scores)
• Turnaround time (TAT) for cashless approvals
• Accuracy in claims audit and documentation resulting in savings
• Reduction in escalations and complaints
• Feedback quality and service improvement initiatives

Preferred candidate profile

Qualifications & Experience

• Graduate in any discipline (Healthcare/Insurance background preferred)
• 1-2 years of experience in health insurance, TPA, or hospital coordination roles
• Prior experience in cashless claims processing or field support is an added advantage