Dedicated Claims Specialist

Ovii's Interpretation of the Role

The Dedicated Claims Specialist will manage end‑to‑end reimbursement claims for corporate group medical policies, delivering prompt, accurate service through multiple support channels. The role requires strong knowledge of medical insurance, documentation analysis, and coordination with insurers, TPAs and hospitals.

Role Snapshot

• End‑to‑end group medical claim processing
• Customer support via Freshchat, Ozontel, Freshdesk
• Medical documentation and policy analysis
• Liaison with insurers, TPAs and hospitals
• Escalation handling with customer‑centric focus
• Detail‑oriented claim verification

Must-Have Requirements

• In-depth knowledge of corporate group medical insurance policies and claims processing
• Ability to understand medical terminology, treatment procedures, and health‑related documentation
• Proficiency in Ozontel, Freshdesk, or similar customer support and claims management tools
• Strong communication and problem‑solving skills
• Attention to detail
• claims processing
• CRM

Nice-to-Have Signals

• Bachelor’s degree in healthcare, insurance, or related field

Work Setup

• Location: Mumbai, India
• Work mode: ONSITE
• Employment type: Full-Time

Not Specified in JD

• Visa sponsorship
• Salary range
• Remote eligibility
• Education requirement
• Certifications
• Relocation
• Notice period
• Travel
• Security clearance
• Coding test
• Portfolio
• GitHub
• Writing sample
• Cover letter

What You'll Likely Work On

• Process reimbursement claims from submission through settlement for group medical corporate policies
• Respond to claim‑related queries using Freshchat, Ozontel and Freshdesk
• Review medical records, treatment procedures and policy terms to validate claims
• Coordinate with internal teams, insurers, TPAs and hospitals to ensure smooth settlements
• Manage and resolve claim escalations while maintaining a customer‑first approach
• Collaborate with cross‑functional partners to improve claim workflows

Good Fit If You Have

• Experience in CRM or customer‑service roles within insurance
• Familiarity with TPA processes and hospital network coordination
• Ability to thrive in a fast‑paced, detail‑driven environment