Employee Benefits-Claims

Role & responsibilities

• Handle day-to-day Employee Benefits claims, primarily Group Mediclaim (GMC) and Group Personal Accident (GPA).
• Coordinate with clients, employees, TPAs and insurance companies for claim processing and resolution.
• Follow up on pending claims, documents and approvals.
• Verify claim documents and ensure completeness before submission.
• Maintain claim trackers and provide regular updates to clients.
• Address employee/client queries related to claim status, documentation and settlement.
• Escalate critical or delayed claims to the appropriate stakeholders.
• Maintain proper records and MIS of claims handled.
• Ensure timely and professional client servicing.

Preferred candidate profile

• 1-2 years of experience in Employee Benefits Claims / Health Insurance Claims.
• Candidates from TPA, Insurance Broking or Insurance Company background preferred.
• Exposure to GMC/GPA claims will be an advantage.
• Good communication and coordination skills.
• Strong follow-up and problem-solving ability.
• Good knowledge of MS Excel and basic MIS reporting.
• Customer/client-service orientation is essential.