Healthcare Support Representative

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Healthcare Support Representative based in India.

This role offers the opportunity to support a modern healthcare operations environment focused on improving the experience of members, providers, and healthcare stakeholders. You will serve as a key point of contact, providing compassionate support while helping resolve complex healthcare inquiries and operational challenges. The position combines customer advocacy, claims support, and process improvement responsibilities within a digital-first setting. You will collaborate with cross-functional teams to ensure accurate, timely, and compliant healthcare service delivery. This is an impactful opportunity for a healthcare professional who enjoys problem-solving, building trust, and improving patient and provider experiences. The ideal candidate will bring strong healthcare knowledge, attention to detail, and a commitment to delivering high-quality support.

Accountabilities:: The Healthcare Support Representative will play a critical role in managing healthcare member and provider interactions while supporting claims operations and service improvements.

Handle inbound and outbound member and provider inquiries through phone, email, and chat channels with professionalism, empathy, and efficiency.

Provide accurate guidance on benefits, eligibility, coverage details, claims status, prior authorizations, billing questions, reimbursement policies, and provider support processes.

Research, process, and resolve healthcare claims issues, including adjustments, denials, appeals, discrepancies, payment concerns, and overpayment reviews.

Verify coverage requirements, eligibility information, and documentation accuracy while following established healthcare workflows and compliance standards.

Conduct follow-ups with members and providers to ensure timely resolution, satisfaction, and continuity of service.

Maintain accurate documentation of interactions, claims activities, and operational procedures.

Support provider outreach activities, including documentation collection, data updates, and claim resolution efforts.

Collaborate with internal teams and external partners to address complex cases and improve operational processes.

Identify recurring issues, recommend improvements, and contribute to quality assurance and workflow optimization initiatives.

Maintain confidentiality and compliance with healthcare regulations, including HIPAA and other applicable standards.

Requirements:

The ideal candidate will have experience in healthcare operations, customer support, and/or claims management, with strong communication skills and the ability to manage detailed processes in a fast-paced environment.

3–5 years of experience in a healthcare payer, third-party administrator (TPA), health insurance, claims operations, or healthcare contact center environment.

Strong understanding of healthcare insurance concepts, benefits, eligibility, medical terminology, and claims lifecycle management.

Excellent English verbal and written communication skills with a service-oriented and empathetic approach.

Strong analytical thinking, problem-solving abilities, attention to detail, and sound judgment.

Ability to manage multiple priorities while maintaining accuracy and professionalism in a digital-first work environment.

Experience using Microsoft Office Suite and customer service, claims processing, or healthcare administration systems.

Experience with payer portals, EDI standards, CRM platforms, or healthcare technology tools is preferred.

Familiarity with claims types such as facility, DME, behavioral health, or high-cost claims is an advantage.

Knowledge of payment integrity, provider relations, medical billing, consolidated billing platforms, or alternative payment models is a plus.

Associate or bachelor’s degree in healthcare administration, business, or a related field is preferred.

Ability to support USA contact center operating hours and participate in a rotating on-call schedule when required.

Benefits:

Competitive compensation package based on experience, qualifications, and relevant certifications.

Salary range of ₹500,000 - ₹1,500,000 INR.

Remote work opportunity.

Opportunity to contribute to healthcare transformation initiatives within a growing, technology-driven environment.

Exposure to diverse healthcare operations, claims management, and member advocacy functions.

Collaborative workplace focused on innovation, continuous improvement, and professional growth.

Inclusive environment that values diversity and equal opportunity.

How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best!  Why Apply Through Jobgether?    Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.     #LI-CL1