Claims Coordinator Team

Key Responsibilities 

• Scan and process claim-related documents as per the applicable process, including maintaining the required scanning sequence and timely document handling. 

• Collect, review and organize documents required for claim processing and ensure applicable documents are uploaded/recorded in the designated systems before further processing. 

• Make phone calls to patients, hospitals and relevant stakeholders for case-related information, document requirements, pending items, queries and follow-up. 

• Communicate with patients through WhatsApp and approved communication channels for document requests, updates, clarifications and other case-related requirements. 

• Call insurance companies/TPAs to obtain and verify relevant patient policy details, eligibility-related information, claim information and other details required for processing the case. 

• Coordinate with the IDE/client servicing team, patients, hospitals, insurers/TPAs and internal teams to resolve documentation and claim-related requirements. 

• Support initial approval and claim-processing activities as assigned, including checking applicable documentation and case requirements. 

• Scan physical claim documents such as identity documents, discharge documents, receipts and investigation reports, and check case-specific supporting documents where applicable. 

• Handle patient, hospital and TPA queries through the appropriate team/channel, follow up for resolution and escalate unresolved or delayed cases as required. 

• Support reopened cases and related document preparation/dispatch when required, including cases involving short settlement or other claim-related issues. 

• Maintain accurate case information, document status and required updates in OCTA and other designated trackers/systems. 

• Maintain assigned daily Excel/productivity records and keep pending case information updated. 

• Coordinate with internal teams through calls, WhatsApp and other approved communication channels to ensure timely movement and closure of assigned cases. 

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