PlanCover.com
Website:
plancover.com
Job details:
Company Description
PlanCover transforms the way businesses manage and purchase commercial insurance by leveraging deep domain expertise to deliver customized, efficient, and transparent insurance solutions. With advanced technology and analytics, PlanCover enables companies to gain insights into risk management and implement cost-effective insurance strategies across critical areas like employee wellbeing, data privacy, directors indemnity, and more. The company has supported over 1,000 businesses with exceptional service and scalable solutions to foster growth and mitigate risks. By addressing the unique needs of diverse industries, PlanCover is driving innovation and excellence in commercial insurance.
Role Description
The Strategic Accounts Servicing Team is responsible for managing and supporting health insurance claims for key corporate clients. The team ensures smooth coordination between employees, hospitals, and insurance companies to deliver timely claim processing and effective support.
This role focuses on end-to-end claims management, providing assistance to employees during hospitalization, claim submission, and claim resolution. The role may also require implant support at the client location and hospital visits to assist employees during claim processing or admission.
Key Responsibilities
- Manage end-to-end cashless and reimbursement health insurance claims for employees.
- Verify policy coverage and eligibility as per policy terms and conditions.
- Act as a single point of contact for employees regarding claim-related queries.
- Provide support to employees during hospitalisation, claim documentation, and approvals.
- Coordinate with insurance companies, TPAs, hospitals, and internal stakeholders for claim processing.
- Follow up proactively with insurers and hospitals to ensure timely claim approvals and settlements.
- Assist employees in hospital visits when required for smooth claim processing.
- Maintain proper records of claim status, communication, and documentation.
- Ensure compliance with service level agreements (SLA), accuracy, and turnaround time.
- Work closely with HR teams and employees of corporate clients to provide a smooth claims experience.
Role Requirements
- Minimum 2 years of experience in health insurance claims handling.
- Experience in cashless claims/reimbursement claims / TPA coordination preferred.
- Good communication skills (calls and emails).
- Willingness to visit hospitals and support employees during claims processing when required.
- Two-wheeler (bike) is required for local travel and hospital visits.
- Candidate should be comfortable with implant roles at client locations if required.
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