Associate, Cashless Claims (Remote, Mumbai)
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.About JobThe Cashless Claims Associate provides on-ground support to insured members during hospitalization, facilitating seamless cashless claim processing from admission through discharge. This position requires presence at hospital premises to coordinate between patient, hospital administration, and insurance providers, ensuring efficient claim settlement while delivering superior customer service in accordance with organizational policies and insurance regulations.Role ResponsibilitiesPatient AssistanceProvide in-person support to insured members and families during hospitalizationVerify network hospital status assist with pre-authorization, claim queries, and discharge formalitiesExplain policy coverage, exclusions, and cashless claims processClaims CoordinationCollect required documentation (ID proofs, medical records, discharge summaries)Validate billing details and ensure accuracy of pre-authorization approvalsMonitor claim progress and coordinate enhancement requestsStakeholder ManagementLiaise between patients, hospital insurance desks, and insurance companiesResolve claim-related disputes and queries promptlyEscalate cases per established protocols and timelinesDocumentation & ComplianceEnsure complete and accurate medical documentation collectionVerify final bills before submission to insurersMaintain records of payments and reimbursement-eligible expensesFeedback CollectionGather patient feedback to improve service quality and the claims process, reporting insights to management.Role Requirements1-2 years in insurance claims with customer-facing responsibilitiesProficiency in English, Hindi, and local languageStrong communication and negotiation abilitiesKnowledge of health insurance processes and terminologyMandatory: Two-wheeler with valid driving license apply to this job