| Job Title | Claims Executive |
| Company Name | PhonePe Limited |
| Job Category | Insurance / Claims |
| Department | Insurance Business |
| Location | Bengaluru, Karnataka, India |
| Work Location | Salarpuria Softzone, Bellandur, Bengaluru – 560103 |
| Employment Type | Contract |
| Experience Required | 2–4 years in Health Insurance Claims Processing |
| Industry Experience | Prior experience in Insurance / TPA industry required |
| Education | Bachelor’s Degree in Life Sciences, Pharmacy, Medical Science, or Nursing preferred |
| Role Overview | Handle and resolve escalated health insurance claims while coordinating with customers, PhonePe RMs, insurers, and TPAs. |
| Claims Management | Manage cashless and reimbursement escalated claims from end to end. |
| Policy Verification | Verify policy coverage, eligibility, medical records, and claim requirements. |
| Stakeholder Coordination | Coordinate with insurers and TPAs for additional information, clarification, and timely claim resolution. |
| Customer Service | Handle escalated customer concerns with clear, empathetic, and effective communication. |
| Reporting & Analysis | Track insurer-wise performance and claim cycle times to identify delays and improve processes. |
| Key Skills | Negotiation, Problem-Solving, Attention to Detail, Resilience, Communication |
| Domain Knowledge | Strong understanding of Health Insurance Claims, regulations, and terminology |
| Key KPIs | Escalated Claim Resolution TAT, Customer Satisfaction (CSAT), Insurer-wise Claims Cycle Time |
