Insurance Desk Expert (Claims Process)

About WeAssist : The Company facilitates medical funding for eligible patients who may need financial support for hospitalization. The team coordinates with hospitals, patients, internal teams, insurance/claims stakeholders, and funding partners to support the applicable process. The Company uses its own ERP platform, OCTA, for managing cases, documents, and related operational records. 

About the Role 

This is an office-based Client Servicing role based in Bangalore. The employee will coordinate with patients, hospital teams, and internal teams primarily through calls and other approved communication channels. The role may also involve document handling and, when required, visit nearby hospitals to collect pending or required documents. 

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.