Strategic Account Servicing - Customer Success

As a member of the Strategic Accounts Servicing Team at Plum, your role will involve dedicated processing and servicing of health claims for key strategic accounts. Your primary responsibility will be to ensure streamlined and efficient claims management, delivering timely resolution and exceptional service tailored to the unique needs of each client. By serving as a single point of contact for health claims-related inquiries and processes, you will enhance client satisfaction, promote trust, and drive continuous improvement in service delivery. Your commitment to optimizing claims processing workflows, facilitating effective communication with clients, and leveraging insights to enhance the overall client experience will support the organization's strategic goals. **Role Responsibilities:** - Act as a Claims buddy: Manage end-to-end cashless/reimbursement claims of employees, including verifying policy coverage, reviewing medical records, coordinating with insurers, communicating with end customers, and ensuring accurate and efficient claims processing. - Verify Policy Coverage: Review and verify policy details to ensure claim eligibility according to insurance policy terms and conditions. - Provide Customer Service: Respond to inquiries from customers and stakeholders regarding claim status and related queries via call and email. - Coordinate with Healthcare Providers/Hospitals and Insurance Companies: Communicate with healthcare providers to obtain additional information and clarify details when required. - Resolve Issues: Investigate and resolve discrepancies, errors, or issues during claims processing to ensure timely and accurate resolution. - Work with Internal Stakeholders: Collaborate with all internal stakeholders, HR of the account, and employees to ensure a great experience for the employee. - Proactive Communication: Keep employees informed about the claims status through proactive communication. - Maintain Records: Keep detailed and accurate records of all claim-related activities, communications, and transactions for documentation and audit purposes. - Adhere to Service Level Agreements: Meet or exceed established service level agreements and performance metrics related to claim processing, turnaround time, accuracy, and customer satisfaction. - Achieve NPS of 90+ in the claims handled. **Role Requirements:** - At least 2 years of experience in customer-facing roles. - Past experience in a voice profile would be an added advantage. - Experience in cashless/TPA. In addition, the role will require 5 days of onsite work with rotational week-offs and shifts. As a member of the Strategic Accounts Servicing Team at Plum, your role will involve dedicated processing and servicing of health claims for key strategic accounts. Your primary responsibility will be to ensure streamlined and efficient claims management, delivering timely resolution and exceptional service tailored to the unique needs of each client. By serving as a single point of contact for health claims-related inquiries and processes, you will enhance client satisfaction, promote trust, and drive continuous improvement in service delivery. Your commitment to optimizing claims processing workflows, facilitating effective communication with clients, and leveraging insights to enhance the overall client experience will support the organization's strategic goals. **Role Responsibilities:** - Act as a Claims buddy: Manage end-to-end cashless/reimbursement claims of employees, including verifying policy coverage, reviewing medical records, coordinating with insurers, communicating with end customers, and ensuring accurate and efficient claims processing. - Verify Policy Coverage: Review and verify policy details to ensure claim eligibility according to insurance policy terms and conditions. - Provide Customer Service: Respond to inquiries from customers and stakeholders regarding claim status and related queries via call and email. - Coordinate with Healthcare Providers/Hospitals and Insurance Companies: Communicate with healthcare providers to obtain additional information and clarify details when required. - Resolve Issues: Investigate and resolve discrepancies, errors, or issues during claims processing to ensure timely and accurate resolution. - Work with Internal Stakeholders: Collaborate with all internal stakeholders, HR of the account, and employees to ensure a great experience for the employee. - Proactive Communication: Keep employees informed about the claims status through proactive communication. - Maintain Records: Keep detailed and accurate records of all claim-related activities, communications, and transactions for documentation and audit purposes. - Adhere to Service Level Agreements: Meet or exceed established service level agreements and performance metrics related to claim processing, turnaround time, accuracy, and customer satisfaction. - Achieve NPS of 90+ in the claims handled. **Role Requirements:** - At least 2