Junior Associate – Claim Processing (Hospital Operations)

Junior Associate – Claim Processing (Hospital Operations)

Careers that Change Lives

About Healspan:

At Healspan our team provides seamless, efficient approach to managing healthcare claims. Our journey

is fueled by the passion to make healthcare management effortless for providers and patients alike,

ensuring that every step from claim filing to settlement is smooth and transparent. We are looking to

strengthen the organization by adding the best available people to our team.

Job description

Type- Full Time

Location- Kashipur

Mission of the Position

We are seeking a detail-oriented and efficient Ayushman Insurance claim processor to manage and

process insurance claims under the PMJAY scheme at our client site. The ideal candidate will ensure

timely and accurate processing of claims, maintain comprehensive records, and provide exceptional

support to beneficiaries and clients. The role would be office wherein the quality and accuracy of the

claims processing would be the deliverable expected from the role.

Primary Activities-

● Evaluate and process PMJAY insurance claims, ensuring compliance with guidelines and policies.

● Verify the accuracy and completeness of claim documents submitted by beneficiaries and hospitals

● Liaising with beneficiaries, and other staff member working at client site

● Maintain accurate records of claims processed in the system and ensure timely updates

● Ensure adherence to regulatory requirements and internal policies related to insurance processing

● Provide assistance regarding the claim process, including eligibility, documentation, and status updates

● Generate reports on claim processing metrics and identify areas for improvement

● Responsible for operational efficiency & service delivery

● Ensure compliance with company's policies and operational guidelines

● Escalate related risks and concerns when necessary

● Should have strong client orientation and willingness to maintain a balanced approach when resolving

client complaints

● Create daily, weekly and monthly report on the performance for assigned clients

Must Have – Minimum Requirements

 Must be a graduate or equivalent. Should have at least experience of 1 Year in PMJAY/ Ayushman claim

processing management

 Experience of working in similar profile with healthcare program/ Client management in a prior role

would be preferred

 He/she should be able to deal with ambiguity and navigate through challenges effectively

 Excellent communication in Hindi with basic English communication skill

 Should have sound knowledge of basic computer skills Microsoft Office and web-based portal

Personal Attributes-

 Exceptional interpersonal and organizational skills

 Planning for project implementations and adherence to timelines

 Strategic orientation combined with operational strength/task orientation

 Can work autonomously but is also a team player

 Self-motivated and positive with “Can do” attitude

 Good time manager: Well organized, able to set and reset priorities

Job Type: Full-time

Pay: ₹10,000.21 - ₹20,000.26 per month

Schedule:

• Day shift

Experience:

• Ayushman claim: 1 year (Preferred)

Work Location: In person