Insurance Desk Expert (Claims)

Key Responsibilities 

• Coordinate with patients, hospital teams and internal teams for assigned cases and process requirements. 

• Counsel patients over the call by explaining the applicable WeAssist process, required documents, claim/insurance requirements, approvals, payments and next steps. 

• Complete/fill applicable insurance claim forms using accurate patient, hospitalization, insurance and treatment details. 

• Verify claim-form information against the available documents and obtain required signatures/declarations wherever applicable. 

• Collect, receive and verify patient, insurance, claim and supporting documents and identify missing, incomplete, incorrect or unclear documents. 

• Coordinate with patients and hospital teams for pending documents, corrections, signatures and other case requirements. 

• Upload and maintain required documents and case information in the Company’s ERP platform, OCTA, and keep case records updated. 

• Coordinate and follow up on final approval, discharge-related requirements and other applicable claim/insurance documentation. 

• Handle patient, hospital and TPA-related queries, follow up for resolution and escalate delayed, exceptional or unresolved cases as required. 

• Maintain an Excel sheet for assigned case tracking and follow-up. 

• When required, visit nearby hospitals to collect physical documents or complete necessary document-related coordination. 

• Coordinate with internal teams through calls/WhatsApp and other approved communication channels to ensure timely case movement and closure. 

• Provide reasonable cross-functional / backup support within the team function when assigned by the reporting manager.