Job summary

Job Overview

We are seeking a knowledgeable and customer-focused Health Insurance Specialist to guide clients in selecting the right health insurance plans based on their medical needs, financial preferences, and lifestyle requirements. This role involves policy explanation, case evaluation, claims coordination, and providing expert advice to ensure clients receive maximum value and protection from their coverage.

The ideal candidate should have strong analytical skills, excellent communication, and an in-depth understanding of health insurance products and industry regulations.

Key Responsibilities

1. Client Consultation & Needs Assessment

• Understand clients’ health requirements, financial capacity, and family needs.

• Recommend appropriate health insurance plans and add-ons (riders).

• Provide personalized advice for individuals, families, senior citizens, and corporate clients.

2. Policy Explanation & Guidance

• Educate clients on plan features, coverage, exclusions, waiting periods, premiums, and network hospitals.

• Help customers compare different health plan options and choose the best one.

• Explain medical underwriting, co-pays, deductibles, and policy terms in simple language.

3. Application & Documentation Support

• Assist clients with filling proposal forms and completing KYC requirements.

• Collect and verify necessary medical and financial documentation.

• Coordinate with underwriting teams for policy approvals.

4. Claims Assistance

• Guide clients through claim filing (cashless & reimbursement).

• Help with documentation, follow-ups, and claim escalation if required.

• Coordinate with TPAs, hospitals, and the insurer to ensure timely claim settlement.

5. Customer Relationship Management

• Maintain long-term relationship with clients for renewals and policy upgrades.

• Provide after-sales support, track policy status, and resolve queries.

• Proactively inform customers about new plans, add-ons, and benefits.

6. Compliance & Industry Knowledge

• Stay updated on IRDAI regulations, product updates, and market trends.

• Ensure all processes follow compliance and company guidelines.

• Maintain confidentiality of sensitive customer data.

7. Sales & Growth Contribution

• Achieve monthly and quarterly sales targets.

• Generate leads through referrals, partnerships, and customer interactions.

• Assist in cross-selling related insurance products when appropriate.

Required Skills & Competencies

• Strong knowledge of health insurance products (training provided if fresher)

• Excellent communication & negotiation skills

• Ability to analyze customer needs and recommend suitable plans

• Customer-oriented approach with patience and empathy

• Good understanding of medical terms and documentation

• Proficiency in MS Office, CRM tools, and digital applications

• Strong problem-solving skills, especially in claims handling

• Ability to work independently and meet targets

Qualifications

• Graduation in any field (preferred: Finance, Healthcare, Business, or similar)

• Certification in insurance (IRDAI license) is an advantage

• Experience in insurance sales, TPA, healthcare administration, or BFSI preferred

• Freshers with strong communication skills may apply

Work Benefits

• Attractive salary + performance-based incentives

• Professional training and certification support

• Opportunities for career growth (Senior Specialist, Underwriter, Manager)

• Supportive team environment

• Health insurance and other company benefits (optional)

Why Join Us?

Become part of a mission-driven company dedicated to offering world-class health insurance solutions. As a Health Insurance Specialist, you will help families and individuals make informed and secure decisions for their healthcare needs.