Claims Operations Associate

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March 12

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Reliance Health

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Healthcare Insurance • Telecommunications • Wellness

Reliance Health is a company dedicated to reimagining employee healthcare by providing innovative health benefits suited for businesses in emerging markets. They offer a comprehensive range of health plans tailored to fit businesses of any size, covering proactive treatments, neonatal care, emergencies, and chronic conditions. Through their mobile app, plan members can access telemedicine, virtual doctor appointments, and prescription deliveries, ensuring a convenient and efficient healthcare experience. Reliance Health collaborates with over 3,800 health and wellness partners globally to deliver high-quality clinical services that meet international standards.

201 - 500 employees

Founded 2016

⚕️ Healthcare Insurance

📡 Telecommunications

🧘 Wellness

💰 $40M Series B on 2022-02

📋 Description

• Reliance Health aims to redefine healthcare accessibility, affordability, and delightfulness in Emerging Markets. • The Claims Operations Associate is responsible for managing claims and approvals processes. • Scope includes vetting health insurance claims, reconciling payments, and negotiating tariffs. • 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 providers’ dashboard. • Collaborate with technology and provider relations teams to improve customer satisfaction.

🎯 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.

🏖️ 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 Benefits • We 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.