Claims Operations Associate (Contract)

Reliance Health aims to redefine healthcare accessibility, affordability, and delightfulness in Emerging Markets. Leveraging technology, we've built an integrated health system comprising affordable health insurance, telemedicine services, and a network of partner and proprietary healthcare facilities. This enables us to offer innovative healthcare solutions precisely when our users need them the most.

The Claims Operations Associate is responsible for managing claims and approvals processes, and the scope of work includes vetting health insurance claims and approval from service providers, reconciling payments and negotiating and uploading claim tariffs.

Key Responsibilities

• Examine and approve or reject healthcare providers’ claims to meet set targets.
• Investigate claims for fraud, waste, and abuse.
• Promptly resolve escalated approval requests for care.
• Negotiate tariffs and update the providers’ dashboard and execute other elements of tariff management.
• Collaborate with the technology team to improve the processes claims, tariff and approvals management system.
• Collaborate with customer success and provider relations teams to ensure customer satisfaction goals.

Requirements

• Minimum of a first degree in medicine, nursing or pharmacy and completion of internship or houseman ship.
• Previous experience in a claim examiner role is a major advantage.
• Excellent numeracy, analytical and problem-solving skills.
• A high-level of responsiveness is essential and openness to working shifts including occasional weekends.
• Strong medical and clinical knowledge and experience.
• Excellent interpersonal and communication skills.
• Renumeration: 250k - 300k

Benefits

At Reliance Health, we prioritize our people and their well-being. Our benefits package is designed to support your success, growth, and happiness. Here’s what you’ll enjoy:

• Hybrid, Flexible Environment Experience the best of both worlds with our hybrid setup—work from home when you need focus, and connect with a vibrant, collaborative team in the office.
• Competitive Salary and BenefitsWe offer a salary that’s benchmarked against the best in the industry, ensuring your expertise and impact are fully rewarded.
• Premium Health Insurance Comprehensive health coverage for you and your family, because your well-being comes first.
• Unlimited Leave Take the time you need when you need it—no limits, no questions.
• Meaningful Impact Play a key role in transforming customer experiences and shaping healthcare innovation.
• Collaborative Work Culture Join a supportive, inclusive, and team-focused environment that celebrates diversity.
• Growth Opportunities Access tools, mentorship, and resources to elevate your skills and career.
• Learning Development Allowance We provide an allowance to support your ongoing professional growth and skill enhancement.
• This is more than a job—it's a chance to grow, thrive, and make a real difference. At Reliance Health, your journey matters.

Originally posted on Himalayas