Customer service - Claims

Job DescriptionCustomer Service Executive Claims Location: Chennai Employment Type: Full-time Function: Customer Service / Claims Experience: 13 years in Insurance Claims / Customer Service / Employee Benefits / TPA Operations preferred About the Role We are looking for a Customer Service Executive Claims to be deployed at a clients premises and serve as the primary point of contact for employees requiring assistance with their insurance claims. The role involves end-to-end coordination of employee claims, including collecting and verifying claim documents, assisting employees with claim-related queries, submitting and processing claims, following up with the insurer/TPA, and ensuring timely reimbursement and closure. The candidate should be highly organised, responsive and comfortable handling a large employee population and a high volume of claims while maintaining accuracy and service quality. Key Responsibilities Act as the on-site claims support representative for the client's employees.Assist employees with queries relating to medical insurance claims, reimbursement procedures, documentation and claim status.Collect claim documents from employees and verify them for completeness, accuracy and eligibility.Identify missing or incorrect documents and coordinate with employees for timely submission.Prepare and submit claim documents to the insurer/TPA within the required timelines.Track claims from submission through processing, approval and reimbursement.Follow up proactively with the insurer/TPA on pending, queried or delayed claims.Maintain an updated claim tracker/MIS covering submitted, pending, approved, rejected and settled claims.Ensure claims are processed and followed up promptly and within agreed turnaround times (TAT).Escalate delayed or complicated claims to the appropriate internal/insurance team.Maintain proper records of all claim-related communication and documentation.Provide regular updates to employees on the status of their claims.Handle employee interactions professionally and with appropriate sensitivity, particularly in cases involving hospitalization or significant medical expenses.Coordinate with the client's HR/administration team and Sriyah's internal claims team as required.Ensure confidentiality and proper handling of employee and medical information.Support periodic reporting and reconciliation of claims as required.Key Skills & Competencies Strong customer service and employee handling skills.Good understanding of health insurance claims and reimbursement processes.Strong document verification and attention to detail.Ability to manage multiple claims simultaneously and work under time-sensitive conditions.Strong follow-up and coordination skills.Good written and verbal communication skills in English.Hindi language proficiency is mandatory, as the role involves assisting a diverse employee population.Tamil communication skills would be an added advantage.Good working knowledge of MS Excel and basic MIS reporting.Ability to maintain accurate records and meet defined TATs.Professional, patient and service-oriented approach.Compensation: From 15,000.00 per month Benefits: Health insuranceLife insurancePaid time offProvident FundWork Location: In person .