Cashless Claims Navigator – Field (Mumbai)
Plum Benefits
•Onsite
About The Position
The Cashless Claims Navigator provides on-ground support to insured members during hospitalization, facilitating seamless cashless claim processing from admission through discharge. This position requires presence 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.
Requirements
- 1-2 years in insurance claims with customer-facing responsibilities
- Proficiency in English, Hindi, and local language
- Strong communication and negotiation abilities
- Knowledge of health insurance processes and terminology
- Two-wheeler with valid driving license
Responsibilities
- Provide in-person support to insured members and families during hospitalization
- Verify network hospital status assist with pre-authorization, claim queries, and discharge formalities
- Explain policy coverage, exclusions, and cashless claims process
- Collect required documentation (ID proofs, medical records, discharge summaries)
- Validate billing details and ensure accuracy of pre-authorization approvals
- Monitor claim progress and coordinate enhancement requests
- Liaise between patients, hospital insurance desks, and insurance companies
- Resolve claim-related disputes and queries promptly
- Escalate cases per established protocols and timelines
- Ensure complete and accurate medical documentation collection
- Verify final bills before submission to insurers
- Maintain records of payments and reimbursement-eligible expenses
- Gather patient feedback to improve service quality and the claims process, reporting insights to management.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
