01Overview
Job Description CRM (Health Insurance / Medical Claims)
Company: Accurate Risk Managers & Insurance Brokers Pvt. Ltd.
Location: Hinjewadi & PCMC Area, Pune
Department: Health Insurance / Employee Benefits
Position: CRM Health Insurance / Medical Claims
Employment Type: Full-Time
Job Summary
We are looking for a Client Relationship Manager (CRM) to manage day-to-day employee and client queries at client locations across Hinjewadi and PCMC areas. The role will primarily involve handling Health Insurance / Group Medical Insurance (GMC) and Medical Claims, coordinating with TPAs, insurance companies, hospitals, and internal teams to ensure timely resolution of queries and claims.
Key Responsibilities
Handle day-to-day health insurance and medical claim-related queries at client locations.Assist employees with cashless hospitalization, reimbursement claims, claim status, documentation, approvals, and settlements.Coordinate with TPAs, insurance companies, hospitals, and internal teams for claim resolution.Provide on-site support and guidance to employees regarding their Group Medical Insurance (GMC) benefits.Follow up on pending claims and ensure timely resolution of open cases.Coordinate with the HR/Admin team at client locations for insurance-related matters.Maintain proper records of employee queries, claims, follow-ups, and resolutions.Escalate complex or delayed claims to the appropriate TPA, insurer, or internal team.Build and maintain a strong relationship with clients and employees.Ensure a high level of customer service and client satisfaction.
Candidate Eligibility
Minimum Qualification: Graduate in any discipline.Experience: 14 years of experience in Health Insurance / Medical Claims / TPA / Insurance Broking / Employee Benefits.Prior experience in Group Medical Insurance (GMC) and medical claims will be preferred.Candidate must have a valid two-wheeler driving licence.Candidate should have their own two-wheeler for travelling to client locations.Should be comfortable travelling across Hinjewadi & PCMC areas.Good communication and interpersonal skills.Strong follow-up, coordination, and problem-solving abilities.Good working knowledge of MS Office / MS Excel.Candidates from TPA, Insurance Company, Insurance Broking, or Corporate Health Insurance backgrounds will be preferred.
Key Skills
Health Insurance | Medical Claims | GMC | Cashless Claims | Reimbursement Claims | TPA Coordination | Client Handling | Employee Query Resolution | Customer Relationship Management | Follow-up & Escalation .
