Assistant Manager- Cashless Claims

About Plum

Plum is an employee insurance and health benefits platform focused on making health insurance simple, accessible and inclusive for modern organizations.

Healthcare in India is seeing a phenomenal shift with inflation in healthcare costs 3x that of general inflation. A majority of Indians are unable to afford health insurance on their own; and so as many as 600mn Indians will likely have to depend on employer-sponsored insurance.

Plum is on a mission to provide the highest quality insurance and healthcare to 10 million lives by FY2030, through companies that care. Plum is backed by Tiger Global and Peak XV Partners.

JOB PURPOSE:-

• Assistant Manager will be responsible for processing and managing cashless insurance claims efficiently and accurately, ensuring timely closure to policyholders and seamless coordination with insurance providers
• Drive continuous improvement in claims processing procedures and provide guidance and support to team members to deliver exceptional customer service and achieve departmental targets
  
  
  

PRINCIPAL ACCOUNTABILITIES:-

• Overseeing the end-to-end processing of cashless insurance claims, ensuring adherence to company policies and Terms & conditions of the policy
• Managing a team of claims processors, providing guidance, training, and performance feedback to optimize team performance
• Monitoring claim processing metrics and identifying areas for improvement to enhance efficiency and accuracy
• Collaborating with internal & external stakeholders, such as Onboarding team, Endorsements team Account management team, Hospitals, Insurer’s etc to resolve complex claims issues and ensure a seamless claims experience for employees
• Conducting regular performance reviews and implementing strategies to drive team productivity and meet departmental targets
• Keeping abreast of industry trends and best practices in claims processing to recommend process enhancements and drive continuous improvement initiatives
• Serving as a point of escalation for escalated claims issues and providing timely resolutions to maintain customer satisfaction
• Manage VIP claims (claims of founder, leadership teams, any priority customer) individually and ensure a green channel processing
• Participating in cross-functional projects and initiatives to support the overall strategic goals of the claims department and the organization
  
  
  

Requirements:-

• At least 3-5 years of experience in health insurance claims management, with a focus on cashless claims processing
• Prior experience working in hospitals or healthcare settings, especially in roles related to patient services, billing, or insurance coordination
• Experience in voice profile /Direct customer management
• Excellent verbal and written communication skills for effective interaction