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Medium

Plum is a company that offers an AI-powered personal finance app designed to help users manage their money effectively. The app analyses users' financial transactions, provides insights into their spending habits, and offers personalised recommendations to help them save, invest, and achieve their financial goals. Plum's ultimate mission is to democratise access to financial expertise and tools, making personal finance simple, accessible, and automated for everyone. Their purpose is to empower individuals to take control of their finances, build healthy financial habits, and make informed financial decisions with ease. Plum aims to remove the complexity and barriers often associated with financial management, providing users with the tools and knowledge to improve their financial well-being and secure their financial future.

Finance

Plum

Money, motivated. The smart money app helping +1.5m invest, save and manage their spending.

You should have 1-4 years in Customer Success, strong English skills, familiarity with tools like Intercom and Excel, and a startup background is a plus.

You will onboard corporates, HR/Admins, and employees, coordinate with teams, resolve queries, follow SOPs, and ensure customer retention through exceptional service.

Customer Relations

Product

# Customer Success * Onboarding Specialist * Location:** Bengaluru * Department:** Customer Success * Employment Type:** Full Time * Work Model:** On-site ## 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 the Role You would help employees and employers use their health insurance and health benefits in the most seamless way possible. You understand the importance of customer success and you take pride in going over and beyond to help your customers. You always put your customer first. You have a strong communication skill, and you are passionate about helping people. You can think on the feet to come up with creative solutions for customer issues. ### Roles & Responsibilities: * Onboard corporates, coordinate with internal stakeholders (Sales, AM, Product teams) and external insurers * Onboard HR/Admins and employees on the product * Follow and execute SOP for onboarding with zero deviations * Develop a deep level of understanding and knowledge of the entire product, systems and processes * Respond to customer queries in a timely and accurate way via phone, email or chat * Support corporate escalations on onboarding * Interact with internal and external teams to ensure quick resolution of customer issues on onboarding * Drive 100 PERCENT customer retention by delivering extraordinary service ### Requirements: * You should have at least 1-4 years of experience in Customer Success / Client servicing / Relationship Management * You should possess great command of English (both oral and written) * You should be comfortable using modern tools like Intercom, Slack, Google Suite, Hubspot * If you come from a startup background, it will be a plus * You have a good amount of experience and expertise in dealing with data handling on Excel

# Customer Success * Onboarding Specialist * Location:** Bengaluru * Department:** Customer Success * Employment Type:** Full Time * Work Model:** On-site      ## About PlumPlum 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 the RoleYou would help employees and employers use their health insurance and health benefits in the most seamless way possible. You understand the importance of customer success and you take pride in going over and beyond to help your customers. You always put your customer first. You have a strong communication skill, and you are passionate about helping people. You can think on the feet to come up with creative solutions for customer issues.### Roles & Responsibilities: * Onboard corporates, coordinate with internal stakeholders (Sales, AM, Product teams) and external insurers * Onboard HR/Admins and employees on the product * Follow and execute SOP for onboarding with zero deviations * Develop a deep level of understanding and knowledge of the entire product, systems and processes * Respond to customer queries in a timely and accurate way via phone, email or chat * Support corporate escalations on onboarding * Interact with internal and external teams to ensure quick resolution of customer issues on onboarding * Drive 100 PERCENT customer retention by delivering extraordinary service      ### Requirements: * You should have at least 1-4 years of experience in Customer Success / Client servicing / Relationship Management * You should possess great command of English (both oral and written) * You should be comfortable using modern tools like Intercom, Slack, Google Suite, Hubspot * If you come from a startup background, it will be a plus * You have a good amount of experience and expertise in dealing with data handling on Excel

Plum - Customer Success - Onboarding Specialist - Plum

# Customer Success&lt;br&gt;&lt;br&gt;&lt;ul&gt;&lt;li&gt;Onboarding Specialist&lt;/li&gt;&lt;li&gt;Location:** Bengaluru&lt;/li&gt;&lt;li&gt;Department:** Customer Success&lt;/li&gt;&lt;li&gt;Employment Type:** Full Time&lt;/li&gt;&lt;li&gt;Work Model:** On-site&lt;br&gt;&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;## About Plum&lt;br&gt;&lt;br&gt;Plum is an employee insurance and health benefits platform focused on making health insurance simple, accessible and inclusive for modern organizations.&lt;br&gt;&lt;br&gt;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.&lt;br&gt;&lt;br&gt;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.&lt;br&gt;&lt;br&gt;## About the Role&lt;br&gt;&lt;br&gt;You would help employees and employers use their health insurance and health benefits in the most seamless way possible. You understand the importance of customer success and you take pride in going over and beyond to help your customers. You always put your customer first. You have a strong communication skill, and you are passionate about helping people. You can think on the feet to come up with creative solutions for customer issues.&lt;br&gt;&lt;br&gt;### Roles &amp;amp; Responsibilities:&lt;br&gt;&lt;br&gt;&lt;ul&gt;&lt;li&gt;Onboard corporates, coordinate with internal stakeholders (Sales, AM, Product teams) and external insurers&lt;/li&gt;&lt;li&gt;Onboard HR/Admins and employees on the product&lt;/li&gt;&lt;li&gt;Follow and execute SOP for onboarding with zero deviations&lt;/li&gt;&lt;li&gt;Develop a deep level of understanding and knowledge of the entire product, systems and processes&lt;/li&gt;&lt;li&gt;Respond to customer queries in a timely and accurate way via phone, email or chat&lt;/li&gt;&lt;li&gt;Support corporate escalations on onboarding&lt;/li&gt;&lt;li&gt;Interact with internal and external teams to ensure quick resolution of customer issues on onboarding&lt;/li&gt;&lt;li&gt;Drive 100 PERCENT customer retention by delivering extraordinary service&lt;br&gt;&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;### Requirements:&lt;br&gt;&lt;br&gt;&lt;ul&gt;&lt;li&gt;You should have at least 1-4 years of experience in Customer Success / Client servicing / Relationship Management&lt;/li&gt;&lt;li&gt;You should possess great command of English (both oral and written)&lt;/li&gt;&lt;li&gt;You should be comfortable using modern tools like Intercom, Slack, Google Suite, Hubspot&lt;/li&gt;&lt;li&gt;If you come from a startup background, it will be a plus&lt;/li&gt;&lt;li&gt;You have a good amount of experience and expertise in dealing with data handling on Excel&lt;/li&gt;&lt;/ul&gt;

Plum - Customer Success - Onboarding Specialist

You need 2-6 years in B2B sales, strong communication skills, customer empathy, problem-solving ability, cross-functional teamwork experience, and familiarity with tools like Intercom and Hubspot.

You will manage MM customer relationships, ensure seamless benefits usage, oversee policy placements, execute renewals, drive upselling, and maintain high customer retention through exceptional service.

Sales & Business Development

: Account Manager - Mid Markets Bengaluru Business: 2. Sales / Employment Type: Full Time / Location: On-site 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 The Role Having found exceptional product/market fit, were in the midst of transitioning from 'start-up' to scale-up, and looking for account managers to capitalize on the huge demand for our product. We are looking for passionate entrepreneurs, builders and straight up hustlers to help us build something special. Were looking for outstanding account managers who have consistently delivered high customer satisfaction, and thrive in taking full ownership of delivering delight to customers. Youll be an articulate presenter and a strategic planner but above all, dynamic and goal-oriented. We dont pretend that itll be easy - joining a company and embarking on the scale-up phase is an amazing challenge, pushing well beyond the boundaries of natural growth cycles. Youll move quicker than feels comfortable, and be brilliant at continually re-prioritizing what must get done to keep Plum growing month over month at the pace of the fastest growing SaaS companies in history. Roles And Responsibilities * You would be the face of Plum to our MM customers. * You would help employees and employers use their health insurance and health benefits in the most seamless way possible. * You would develop a deep level of understanding and knowledge of the entire product, systems and processes. * You would oversee insurance policy placement, uploading of health IDs, and configuring of benefits. * You would devise & implement engagement plans. * You would execute upsell and x-sell opportunities. * You would execute policy renewals. * You would coordinate with insurance partners for resolution/clarifications if needed. * You would drive 100 PERCENT customer retention by delivering extraordinary service. Experience and Qualifications: * At least 2-6 years of experience in B2B sales and customer facing role. * Very strong written and verbal communication. * High customer empathy. * Strong problem solver, can hustle to unblock customers. * Ability to work with cross functional teams to resolve issues. * Comfortable using modern tools like Intercom, Slack, Google Suite, Hubspot. * Strong adherence to SLAs and processes.

: Account Manager - Mid Markets BengaluruBusiness: 2. Sales /Employment Type: Full Time /Location: On-siteAbout PlumPlum 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 The RoleHaving found exceptional product/market fit, were in the midst of transitioning from 'start-up' to scale-up, and looking for account managers to capitalize on the huge demand for our product.We are looking for passionate entrepreneurs, builders and straight up hustlers to help us build something special. Were looking for outstanding account managers who have consistently delivered high customer satisfaction, and thrive in taking full ownership of delivering delight to customers. Youll be an articulate presenter and a strategic planner but above all, dynamic and goal-oriented.We dont pretend that itll be easy - joining a company and embarking on the scale-up phase is an amazing challenge, pushing well beyond the boundaries of natural growth cycles. Youll move quicker than feels comfortable, and be brilliant at continually re-prioritizing what must get done to keep Plum growing month over month at the pace of the fastest growing SaaS companies in history.Roles And Responsibilities * You would be the face of Plum to our MM customers. * You would help employees and employers use their health insurance and health benefits in the most seamless way possible. * You would develop a deep level of understanding and knowledge of the entire product, systems and processes. * You would oversee insurance policy placement, uploading of health IDs, and configuring of benefits. * You would devise & implement engagement plans. * You would execute upsell and x-sell opportunities. * You would execute policy renewals. * You would coordinate with insurance partners for resolution/clarifications if needed. * You would drive 100 PERCENT customer retention by delivering extraordinary service.      Experience and Qualifications: * At least 2-6 years of experience in B2B sales and customer facing role. * Very strong written and verbal communication. * High customer empathy. * Strong problem solver, can hustle to unblock customers. * Ability to work with cross functional teams to resolve issues. * Comfortable using modern tools like Intercom, Slack, Google Suite, Hubspot. * Strong adherence to SLAs and processes.

Plum - Account Manager - Mid Markets - Plum

&lt;strong&gt;: Account Manager - Mid Markets Bengaluru&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;strong&gt;Business&lt;/strong&gt;: 2. Sales /&lt;br&gt;&lt;br&gt;&lt;strong&gt;Employment Type&lt;/strong&gt;: Full Time /&lt;br&gt;&lt;br&gt;&lt;strong&gt;Location&lt;/strong&gt;: On-site&lt;br&gt;&lt;br&gt;&lt;strong&gt;About Plum&lt;br&gt;&lt;br&gt;&lt;/strong&gt;Plum is an employee insurance and health benefits platform focused on making health insurance simple, accessible and inclusive for modern organizations.&lt;br&gt;&lt;br&gt;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.&lt;br&gt;&lt;br&gt;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.&lt;br&gt;&lt;br&gt;&lt;strong&gt;About The Role&lt;br&gt;&lt;br&gt;&lt;/strong&gt;Having found exceptional product/market fit, were in the midst of transitioning from 'start-up' to scale-up, and looking for account managers to capitalize on the huge demand for our product.&lt;br&gt;&lt;br&gt;We are looking for passionate entrepreneurs, builders and straight up hustlers to help us build something special. Were looking for outstanding account managers who have consistently delivered high customer satisfaction, and thrive in taking full ownership of delivering delight to customers. Youll be an articulate presenter and a strategic planner but above all, dynamic and goal-oriented.&lt;br&gt;&lt;br&gt;We dont pretend that itll be easy - joining a company and embarking on the scale-up phase is an amazing challenge, pushing well beyond the boundaries of natural growth cycles. Youll move quicker than feels comfortable, and be brilliant at continually re-prioritizing what must get done to keep Plum growing month over month at the pace of the fastest growing SaaS companies in history.&lt;br&gt;&lt;br&gt;&lt;strong&gt;Roles And Responsibilities&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;You would be the face of Plum to our MM customers.&lt;/li&gt;&lt;li&gt;You would help employees and employers use their health insurance and health benefits in the most seamless way possible.&lt;/li&gt;&lt;li&gt;You would develop a deep level of understanding and knowledge of the entire product, systems and processes.&lt;/li&gt;&lt;li&gt;You would oversee insurance policy placement, uploading of health IDs, and configuring of benefits.&lt;/li&gt;&lt;li&gt;You would devise &amp;amp; implement engagement plans.&lt;/li&gt;&lt;li&gt;You would execute upsell and x-sell opportunities.&lt;/li&gt;&lt;li&gt;You would execute policy renewals.&lt;/li&gt;&lt;li&gt;You would coordinate with insurance partners for resolution/clarifications if needed.&lt;/li&gt;&lt;li&gt;You would drive 100 PERCENT customer retention by delivering extraordinary service.&lt;br&gt;&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;&lt;strong&gt;Experience and Qualifications:&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;At least 2-6 years of experience in B2B sales and customer facing role.&lt;/li&gt;&lt;li&gt;Very strong written and verbal communication.&lt;/li&gt;&lt;li&gt;High customer empathy.&lt;/li&gt;&lt;li&gt;Strong problem solver, can hustle to unblock customers.&lt;/li&gt;&lt;li&gt;Ability to work with cross functional teams to resolve issues.&lt;/li&gt;&lt;li&gt;Comfortable using modern tools like Intercom, Slack, Google Suite, Hubspot.&lt;/li&gt;&lt;li&gt;Strong adherence to SLAs and processes.&lt;/li&gt;&lt;/ul&gt;

Plum - Account Manager - Mid Markets

You need an MBBS, BDS, BAMS, or BHMS degree, 5+ years in clinical/claims adjudication, strong analytical skills, and proficiency in medical documentation and digital tools.

You will review health insurance claims, correct decisions, analyze documentation, identify errors, prepare dispute reports, ensure compliance, maintain confidentiality, and collaborate with insurance teams.

Healthcare

Medical Evaluation Specialist Location: Bengaluru Department: Customer Success Employment Type: Full Time Work Arrangement: On-site 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. Job Overview We are seeking qualified medical professionals to join our team as Medical Evaluation Specialist. The ideal candidate will leverage their medical expertise to critically review health insurance claim decisions, ensuring accuracy, adherence to medical protocols, and fair assessment of medical conditions. This role plays a vital part in safeguarding the integrity of medical claims, ensuring that patient care and appropriate medical practices are at the forefront of decision-making. Key Responsibilities * Comprehensive Claim Reviews: Conduct thorough evaluations of health insurance claim decisions, ensuring compliance with medical protocols and standards for the rejected claims. * Decision Correction: Take up rejected claims post review with Insurance companies or Third Party Administrator (TPA) doctors/adjudicators for reconsideration/corrections by building a case file with medical rationale/ medical protocols, proofs from treating doctors etc. * Documentation Analysis: Analyze claim medical documentation in detail against policy terms and conditions to establish the validity of claims. * Error Identification: Identify and document potential assessment errors, procedural gaps, and misinterpretations of medical evidence that may affect claim outcomes. * Dispute Reporting: Prepare detailed and well-structured dispute reports for claims that do not conform to appropriate medical assessment standards, articulating the rationale and evidence base. * Collaboration: Work closely with insurance teams to provide medical insights and recommendations aimed at improving claim processes and outcomes. * Confidentiality: Maintain strict confidentiality regarding patient and claim-related information, adhering to all privacy regulations. * Regulatory Compliance: Ensure all processes comply with Indian medical insurance regulations and guidelines, staying updated on the latest changes. * Report Preparation: Create clear, concise, and professionally formatted review reports for internal and external stakeholders. Interacting with treating doctors for case discussions as per requirement. * Continuous Training: Participate in ongoing training and development opportunities to remain informed on medical insurance protocols and best practices. Education and Professional Qualifications * Required Educational Background: A mandatory degree in one of the following with a minimum of 5 years of clinical/claims adjudication (insurance) experience or both: * MBBS (Bachelor of Medicine, Bachelor of Surgery) * BDS (Dental Degree) * BAMS or BHMS Essential Skills * Strong understanding of medical terminology and clinical procedures. * Exceptional analytical and critical thinking abilities. * Excellent written and verbal communication skills. * Proficiency in medical documentation and record review processes. * High attention to detail and accuracy. * Ability to work independently while also collaborating effectively within a team. * Familiarity with the Indian healthcare system and insurance practices. Preferred Work Experience * Experience between 5 to 10 years of clinical/claims adjudication (insurance) experience or both: * Understanding of health insurance policies and claim assessment processes. * Experience with digital documentation and review systems. * Additional certifications related to medical insurance or healthcare administration are a plus. Technical Requirements * Proficient computer skills. * Strong data analysis capabilities. * Comfortable using digital claim review platforms and tools. Working Conditions * This is an office-based role with the potential for hybrid work arrangements. * Regular working hours with occasional needs for extended review periods to meet deadlines. * Predominantly sedentary work involving extensive computer use and documentation review. Compensation and Benefits * Ranges from competitive to best in the industry. * Comprehensive health insurance coverage. * Opportunities for professional development and continuous learning. * Performance-based incentives.

Medical Evaluation SpecialistLocation: BengaluruDepartment: Customer SuccessEmployment Type: Full TimeWork Arrangement: On-siteAbout PlumPlum 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.Job OverviewWe are seeking qualified medical professionals to join our team as Medical Evaluation Specialist. The ideal candidate will leverage their medical expertise to critically review health insurance claim decisions, ensuring accuracy, adherence to medical protocols, and fair assessment of medical conditions. This role plays a vital part in safeguarding the integrity of medical claims, ensuring that patient care and appropriate medical practices are at the forefront of decision-making.Key Responsibilities * Comprehensive Claim Reviews: Conduct thorough evaluations of health insurance claim decisions, ensuring compliance with medical protocols and standards for the rejected claims. * Decision Correction: Take up rejected claims post review with Insurance companies or Third Party Administrator (TPA) doctors/adjudicators for reconsideration/corrections by building a case file with medical rationale/ medical protocols, proofs from treating doctors etc. * Documentation Analysis: Analyze claim medical documentation in detail against policy terms and conditions to establish the validity of claims. * Error Identification: Identify and document potential assessment errors, procedural gaps, and misinterpretations of medical evidence that may affect claim outcomes. * Dispute Reporting: Prepare detailed and well-structured dispute reports for claims that do not conform to appropriate medical assessment standards, articulating the rationale and evidence base. * Collaboration: Work closely with insurance teams to provide medical insights and recommendations aimed at improving claim processes and outcomes. * Confidentiality: Maintain strict confidentiality regarding patient and claim-related information, adhering to all privacy regulations. * Regulatory Compliance: Ensure all processes comply with Indian medical insurance regulations and guidelines, staying updated on the latest changes. * Report Preparation: Create clear, concise, and professionally formatted review reports for internal and external stakeholders. Interacting with treating doctors for case discussions as per requirement. * Continuous Training: Participate in ongoing training and development opportunities to remain informed on medical insurance protocols and best practices.      Education and Professional Qualifications * Required Educational Background: A mandatory degree in one of the following with a minimum of 5 years of clinical/claims adjudication (insurance) experience or both:    * MBBS (Bachelor of Medicine, Bachelor of Surgery)    * BDS (Dental Degree)    * BAMS or BHMSEssential Skills * Strong understanding of medical terminology and clinical procedures. * Exceptional analytical and critical thinking abilities. * Excellent written and verbal communication skills. * Proficiency in medical documentation and record review processes. * High attention to detail and accuracy. * Ability to work independently while also collaborating effectively within a team. * Familiarity with the Indian healthcare system and insurance practices.      Preferred Work Experience * Experience between 5 to 10 years of clinical/claims adjudication (insurance) experience or both:    * Understanding of health insurance policies and claim assessment processes.    * Experience with digital documentation and review systems.    * Additional certifications related to medical insurance or healthcare administration are a plus.Technical Requirements * Proficient computer skills. * Strong data analysis capabilities. * Comfortable using digital claim review platforms and tools.      Working Conditions * This is an office-based role with the potential for hybrid work arrangements. * Regular working hours with occasional needs for extended review periods to meet deadlines. * Predominantly sedentary work involving extensive computer use and documentation review.      Compensation and Benefits * Ranges from competitive to best in the industry. * Comprehensive health insurance coverage. * Opportunities for professional development and continuous learning. * Performance-based incentives.

Plum - Medical Evaluation Specialist - Plum

&lt;strong&gt;Medical Evaluation Specialist&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;strong&gt;Location:&lt;/strong&gt; Bengaluru&lt;br&gt;&lt;br&gt;&lt;strong&gt;Department:&lt;/strong&gt; Customer Success&lt;br&gt;&lt;br&gt;&lt;strong&gt;Employment Type:&lt;/strong&gt; Full Time&lt;br&gt;&lt;br&gt;&lt;strong&gt;Work Arrangement:&lt;/strong&gt; On-site&lt;br&gt;&lt;br&gt;&lt;strong&gt;About Plum&lt;br&gt;&lt;br&gt;&lt;/strong&gt;Plum is an employee insurance and health benefits platform focused on making health insurance simple, accessible and inclusive for modern organizations.&lt;br&gt;&lt;br&gt;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.&lt;br&gt;&lt;br&gt;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.&lt;br&gt;&lt;br&gt;&lt;strong&gt;Job Overview&lt;br&gt;&lt;br&gt;&lt;/strong&gt;We are seeking qualified medical professionals to join our team as Medical Evaluation Specialist. The ideal candidate will leverage their medical expertise to critically review health insurance claim decisions, ensuring accuracy, adherence to medical protocols, and fair assessment of medical conditions. This role plays a vital part in safeguarding the integrity of medical claims, ensuring that patient care and appropriate medical practices are at the forefront of decision-making.&lt;br&gt;&lt;br&gt;&lt;strong&gt;Key Responsibilities&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;Comprehensive Claim Reviews: Conduct thorough evaluations of health insurance claim decisions, ensuring compliance with medical protocols and standards for the rejected claims.&lt;/li&gt;&lt;li&gt;Decision Correction: Take up rejected claims post review with Insurance companies or Third Party Administrator (TPA) doctors/adjudicators for reconsideration/corrections by building a case file with medical rationale/ medical protocols, proofs from treating doctors etc.&lt;/li&gt;&lt;li&gt;Documentation Analysis: Analyze claim medical documentation in detail against policy terms and conditions to establish the validity of claims.&lt;/li&gt;&lt;li&gt;Error Identification: Identify and document potential assessment errors, procedural gaps, and misinterpretations of medical evidence that may affect claim outcomes.&lt;/li&gt;&lt;li&gt;Dispute Reporting: Prepare detailed and well-structured dispute reports for claims that do not conform to appropriate medical assessment standards, articulating the rationale and evidence base.&lt;/li&gt;&lt;li&gt;Collaboration: Work closely with insurance teams to provide medical insights and recommendations aimed at improving claim processes and outcomes.&lt;/li&gt;&lt;li&gt;Confidentiality: Maintain strict confidentiality regarding patient and claim-related information, adhering to all privacy regulations.&lt;/li&gt;&lt;li&gt;Regulatory Compliance: Ensure all processes comply with Indian medical insurance regulations and guidelines, staying updated on the latest changes.&lt;/li&gt;&lt;li&gt;Report Preparation: Create clear, concise, and professionally formatted review reports for internal and external stakeholders. Interacting with treating doctors for case discussions as per requirement.&lt;/li&gt;&lt;li&gt;Continuous Training: Participate in ongoing training and development opportunities to remain informed on medical insurance protocols and best practices.&lt;br&gt;&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;&lt;strong&gt;Education and Professional Qualifications&lt;/strong&gt; &lt;br&gt;&lt;br&gt;&lt;ul&gt;&lt;li&gt;Required Educational Background: A mandatory degree in one of the following with a minimum of 5 years of clinical/claims adjudication (insurance) experience or both:&lt;/li&gt;&lt;ul&gt;&lt;li&gt;MBBS (Bachelor of Medicine, Bachelor of Surgery)&lt;/li&gt;&lt;li&gt;BDS (Dental Degree)&lt;/li&gt;&lt;li&gt;BAMS or BHMS&lt;/li&gt;&lt;/ul&gt;&lt;/ul&gt; &lt;strong&gt;Essential Skills&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;Strong understanding of medical terminology and clinical procedures.&lt;/li&gt;&lt;li&gt;Exceptional analytical and critical thinking abilities.&lt;/li&gt;&lt;li&gt;Excellent written and verbal communication skills.&lt;/li&gt;&lt;li&gt;Proficiency in medical documentation and record review processes.&lt;/li&gt;&lt;li&gt;High attention to detail and accuracy.&lt;/li&gt;&lt;li&gt;Ability to work independently while also collaborating effectively within a team.&lt;/li&gt;&lt;li&gt;Familiarity with the Indian healthcare system and insurance practices.&lt;br&gt;&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;&lt;strong&gt;Preferred Work Experience&lt;/strong&gt; &lt;br&gt;&lt;br&gt;&lt;ul&gt;&lt;li&gt;Experience between 5 to 10 years of clinical/claims adjudication (insurance) experience or both:&lt;/li&gt;&lt;ul&gt;&lt;li&gt;Understanding of health insurance policies and claim assessment processes.&lt;/li&gt;&lt;li&gt;Experience with digital documentation and review systems.&lt;/li&gt;&lt;li&gt;Additional certifications related to medical insurance or healthcare administration are a plus.&lt;/li&gt;&lt;/ul&gt;&lt;/ul&gt; &lt;strong&gt;Technical Requirements&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;Proficient computer skills.&lt;/li&gt;&lt;li&gt;Strong data analysis capabilities.&lt;/li&gt;&lt;li&gt;Comfortable using digital claim review platforms and tools.&lt;br&gt;&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;&lt;strong&gt;Working Conditions&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;This is an office-based role with the potential for hybrid work arrangements.&lt;/li&gt;&lt;li&gt;Regular working hours with occasional needs for extended review periods to meet deadlines.&lt;/li&gt;&lt;li&gt;Predominantly sedentary work involving extensive computer use and documentation review.&lt;br&gt;&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;&lt;strong&gt;Compensation and Benefits&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;Ranges from competitive to best in the industry.&lt;/li&gt;&lt;li&gt;Comprehensive health insurance coverage.&lt;/li&gt;&lt;li&gt;Opportunities for professional development and continuous learning.&lt;/li&gt;&lt;li&gt;Performance-based incentives.&lt;/li&gt;&lt;/ul&gt;

Plum - Medical Evaluation Specialist

You need 10-12 years of experience, 5 in health insurance, a related degree, customer success expertise, strong analytical skills, CRM proficiency, and leadership abilities.

You’ll resolve complex customer queries, engage with corporate clients, support account management, drive operational improvements, and ensure alignment with customer needs and compliance standards.

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. JOB PURPOSE:- We are looking for a dedicated and experienced Customer Relationship Manager to join our Customer Success team within the health insurance sector. This role is pivotal in managing relationships with our corporate clients as well as internal stakeholders. The ideal candidate will possess strong interpersonal skills, a deep understanding of health insurance products, and a commitment to ensuring client satisfaction and success. PRINCIPAL ACCOUNTABILITIES:- * Expertise in Customer Success Functions:- Develop a comprehensive understanding of all functional areas within the Customer Success Team, including Onboarding, Endorsements, Claims Management, and Customer Support * Complex Query Resolution:- Act as the primary point of escalation for internal teams and corporate clients to resolve complex queries related to customer success ( onboarding, endorsements, claims, and customer support). Collaborate with various departments to gather necessary information and provide accurate and timely solutions in line with terms & conditions and regulatory adherence Implement feedback loops to ensure recurring issues are addressed, and solutions are documented for future reference * Corporate Client Engagement:- Participate in corporate client calls, including Quarterly Business Reviews (QBRs), representing the Customer Success Team and ensuring a clear understanding of client needs from an operational perspective. Prepare and present insights and updates on customer success metrics, operational processes, and product offerings to clients, ensuring alignment with their expectations and needs. Build strong, trusting relationships with corporate clients, positioning yourself as a strategic partner in their success * Support for Account Management and Escalations:- Collaborate with account management and escalation teams to analyze and resolve complex escalations effectively, ensuring clear communication regarding insurance regulations and compliance requirements. Provide guidance and operational insights on how to navigate regulatory frameworks and enhance client satisfaction during complex situations * Operational Projects and Efficiency Improvements:- Lead and drive operational projects in collaboration with the product team, identifying areas for simplification and efficiency enhancements within customer success processes. Utilize data analysis and stakeholder feedback to inform project priorities and ensure that improvements align with customer needs and operational capabilities. Monitor the impact of implemented changes, adjusting strategies as necessary to achieve optimal results in service delivery INTERACTIONS:- * Internal Clients:- Endorsement team Onboarding team Products & engineering Other Claims teams Support Inbound Account Management * External Clients:- Client HR’s and leadership WHO CAN APPLY:- * A professional with 10–12 years of total work experience, including a minimum of 5 years in the health insurance industry * Bachelor’s degree in Business, Insurance, or a related field * Proven experience in customer success, account management, or operations in leading B2B or B2C organisations * Preference will be given to candidates having the experience in health insurance industry (Indian or International) and with customer-facing roles. * Strong knowledge of health insurance products, regulatory framework, and customer service best practices * Exceptional analytical and problem-solving skills, with the ability to manage complex situations effectively * Excellent communication and interpersonal skills, with the ability to build relationships across all levels of the organization and with corporate clients * Proficient in CRM software and data analysis tools; ability to leverage data for strategic decision-making * Leadership skills with a focus on team development and cross-functional collaboration

About PlumPlum 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.JOB PURPOSE:-We are looking for a dedicated and experienced Customer Relationship Manager to join our Customer Success team within the health insurance sector. This role is pivotal in managing relationships with our corporate clients as well as internal stakeholders. The ideal candidate will possess strong interpersonal skills, a deep understanding of health insurance products, and a commitment to ensuring client satisfaction and success.PRINCIPAL ACCOUNTABILITIES:- * Expertise in Customer Success Functions:- Develop a comprehensive understanding of all functional areas within the Customer Success Team, including Onboarding, Endorsements, Claims Management, and Customer Support * Complex Query Resolution:- Act as the primary point of escalation for internal teams and corporate clients to resolve complex queries related to customer success ( onboarding, endorsements, claims, and customer support). Collaborate with various departments to gather necessary information and provide accurate and timely solutions in line with terms & conditions and regulatory adherence Implement feedback loops to ensure recurring issues are addressed, and solutions are documented for future reference * Corporate Client Engagement:- Participate in corporate client calls, including Quarterly Business Reviews (QBRs), representing the Customer Success Team and ensuring a clear understanding of client needs from an operational perspective. Prepare and present insights and updates on customer success metrics, operational processes, and product offerings to clients, ensuring alignment with their expectations and needs. Build strong, trusting relationships with corporate clients, positioning yourself as a strategic partner in their success * Support for Account Management and Escalations:- Collaborate with account management and escalation teams to analyze and resolve complex escalations effectively, ensuring clear communication regarding insurance regulations and compliance requirements. Provide guidance and operational insights on how to navigate regulatory frameworks and enhance client satisfaction during complex situations * Operational Projects and Efficiency Improvements:- Lead and drive operational projects in collaboration with the product team, identifying areas for simplification and efficiency enhancements within customer success processes. Utilize data analysis and stakeholder feedback to inform project priorities and ensure that improvements align with customer needs and operational capabilities. Monitor the impact of implemented changes, adjusting strategies as necessary to achieve optimal results in service delivery         INTERACTIONS:- * Internal Clients:-         Endorsement teamOnboarding teamProducts & engineeringOther Claims teamsSupport InboundAccount Management * External Clients:-         Client HR’s and leadershipWHO CAN APPLY:- * A professional with 10–12 years of total work experience, including a minimum of 5 years in the health insurance industry * Bachelor’s degree in Business, Insurance, or a related field * Proven experience in customer success, account management, or operations in leading B2B or B2C organisations * Preference will be given to candidates having the experience in health insurance industry (Indian or International) and with customer-facing roles. * Strong knowledge of health insurance products, regulatory framework, and customer service best practices * Exceptional analytical and problem-solving skills, with the ability to manage complex situations effectively * Excellent communication and interpersonal skills, with the ability to build relationships across all levels of the organization and with corporate clients * Proficient in CRM software and data analysis tools; ability to leverage data for strategic decision-making * Leadership skills with a focus on team development and cross-functional collaboration   

Senior Manager- Customer Experience Partner - Plum

&lt;strong&gt;About Plum&lt;br&gt;&lt;br&gt;&lt;/strong&gt;Plum is an employee insurance and health benefits platform focused on making health insurance simple, accessible and inclusive for modern organizations.&lt;br&gt;&lt;br&gt;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.&lt;br&gt;&lt;br&gt;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.&lt;br&gt;&lt;br&gt;&lt;strong&gt;JOB PURPOSE:- &lt;br&gt;&lt;br&gt;&lt;/strong&gt;We are looking for a dedicated and experienced Customer Relationship Manager to join our Customer Success team within the health insurance sector. This role is pivotal in managing relationships with our corporate clients as well as internal stakeholders. The ideal candidate will possess strong interpersonal skills, a deep understanding of health insurance products, and a commitment to ensuring client satisfaction and success.&lt;br&gt;&lt;br&gt;&lt;strong&gt;PRINCIPAL ACCOUNTABILITIES:- &lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;Expertise in Customer Success Functions:- Develop a comprehensive understanding of all functional areas within the Customer Success Team, including Onboarding, Endorsements, Claims Management, and Customer Support&lt;/li&gt;&lt;li&gt;Complex Query Resolution:- Act as the primary point of escalation for internal teams and corporate clients to resolve complex queries related to customer success ( onboarding, endorsements, claims, and customer support). Collaborate with various departments to gather necessary information and provide accurate and timely solutions in line with terms &amp;amp; conditions and regulatory adherence Implement feedback loops to ensure recurring issues are addressed, and solutions are documented for future reference&lt;/li&gt;&lt;li&gt;Corporate Client Engagement:- Participate in corporate client calls, including Quarterly Business Reviews (QBRs), representing the Customer Success Team and ensuring a clear understanding of client needs from an operational perspective. Prepare and present insights and updates on customer success metrics, operational processes, and product offerings to clients, ensuring alignment with their expectations and needs. Build strong, trusting relationships with corporate clients, positioning yourself as a strategic partner in their success&lt;/li&gt;&lt;li&gt;Support for Account Management and Escalations:- Collaborate with account management and escalation teams to analyze and resolve complex escalations effectively, ensuring clear communication regarding insurance regulations and compliance requirements. Provide guidance and operational insights on how to navigate regulatory frameworks and enhance client satisfaction during complex situations&lt;/li&gt;&lt;li&gt;Operational Projects and Efficiency Improvements:- Lead and drive operational projects in collaboration with the product team, identifying areas for simplification and efficiency enhancements within customer success processes. Utilize data analysis and stakeholder feedback to inform project priorities and ensure that improvements align with customer needs and operational capabilities. Monitor the impact of implemented changes, adjusting strategies as necessary to achieve optimal results in service delivery&lt;br&gt;&lt;br&gt;&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;&lt;strong&gt;INTERACTIONS:- &lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;Internal Clients:- &lt;br&gt;&lt;br&gt;&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;Endorsement team&lt;br&gt;&lt;br&gt;Onboarding team&lt;br&gt;&lt;br&gt;Products &amp;amp; engineering&lt;br&gt;&lt;br&gt;Other Claims teams&lt;br&gt;&lt;br&gt;Support Inbound&lt;br&gt;&lt;br&gt;Account Management&lt;br&gt;&lt;br&gt;&lt;ul&gt;&lt;li&gt;External Clients:- &lt;br&gt;&lt;br&gt;&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;Client HR’s and leadership&lt;br&gt;&lt;br&gt;&lt;strong&gt;WHO CAN APPLY:- &lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;A professional with 10–12 years of total work experience, including a minimum of 5 years in the health insurance industry&lt;/li&gt;&lt;li&gt;Bachelor’s degree in Business, Insurance, or a related field&lt;/li&gt;&lt;li&gt;Proven experience in customer success, account management, or operations in leading B2B or B2C organisations &lt;/li&gt;&lt;li&gt;Preference will be given to candidates having the experience in health insurance industry (Indian or International) and with customer-facing roles. &lt;/li&gt;&lt;li&gt;Strong knowledge of health insurance products, regulatory framework, and customer service best practices&lt;/li&gt;&lt;li&gt;Exceptional analytical and problem-solving skills, with the ability to manage complex situations effectively&lt;/li&gt;&lt;li&gt;Excellent communication and interpersonal skills, with the ability to build relationships across all levels of the organization and with corporate clients&lt;/li&gt;&lt;li&gt;Proficient in CRM software and data analysis tools; ability to leverage data for strategic decision-making&lt;/li&gt;&lt;li&gt;Leadership skills with a focus on team development and cross-functional collaboration&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;

Senior Manager- Customer Experience Partner

You need 15 years in health insurance and 8-10 years in claims operations, a relevant degree, strong analytical skills, leadership abilities, and expertise in cashless and reimbursement claims.

You will lead claims operations, manage daily processing, improve efficiency, resolve errors, share knowledge, enhance transparency, and analyze data for continuous improvement in service delivery.

General Manager - Claims Operations Bengaluru Customer Success 7. Customer Success / Full Time / On-site 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. Job Purpose We are seeking a knowledgeable and experienced General Manager of Claims to be part of our cashless and reimbursement claims team. The incumbent will leverage their deep understanding of insurance to guide the team in navigating complex claims scenarios, ensuring optimal outcomes for our customers. Principal Accountabilities * Leadership and Guidance: Provide expertise and direction to the cashless and reimbursement claims team, drawing upon extensive insurance knowledge to enhance team performance and service delivery. * Manage the end-to-end operations for Claims: Manage daily operations for both Cashless and Reimbursement. The focus will be on daily productivity, efficiency improvement, process improvement, team adherence, and SLA adherence with partners. * Transaction Management: Oversee and monitor daily transactions related to claims processing, ensuring adherence to quality standards and operational efficiency as the claims leader. * Product improvement: Design process changes required to improve efficiency via automation, process re-engineering etc. Liaise with the Plum product team for getting these implemented. * Knowledge Sharing: Promote a culture of knowledge sharing across cross-functional teams, simplifying the payout process and educating stakeholders on claims procedures and best practices. * Error Resolution: Identify processing errors by TPA & insurer and raise them swiftly and get them fixed. Act as an advocate for customers by disputing grey area claims with insurers, utilizing a thorough knowledge of insurance terms and conditions to drive favourable outcomes. Raise disputes for decisions regarding medical understanding or terms interpretation, document gaps etc., and help the Dispute team with all relevant details. * Performance Transparency: Assist clients in understanding claims performance and service statistics regularly, enhancing transparency and trust in the claims process. * Data Analysis and Process Improvement: Engage in continuous data analysis to identify trends and inefficiencies in the claims process, implementing improvements to enhance quality, efficiency, and overall service delivery. INTERACTIONS Internal * Endorsement team * Onboarding team * Products & Engineering * Other Claims teams * Support Inbound * Account Management External * Insurance Companies * TPA claims processing or CRM teams Who can apply? * 15 years of experience required in health insurance - either in an Indian or International insurer. * A minimum of 8-10 years of claims operations experience in health claims. * Bachelors degree in Business, Insurance, or a related field. * Extensive experience in Health Insurance claims management/operations, particularly in cashless and reimbursement claims. * Strong analytical skills with a proven ability to conduct detailed case analyses and data-driven decision-making. * Excellent communication and interpersonal skills, facilitating effective collaboration with internal teams and external partners. * A strong understanding of insurance policies, terms, and conditions, with experience in dispute resolution. * Proven leadership skills, with a focus on developing and motivating teams for high performance.

General Manager - Claims Operations BengaluruCustomer Success 7. Customer Success / Full Time / On-siteAbout PlumPlum 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.Job PurposeWe are seeking a knowledgeable and experienced General Manager of Claims to be part of our cashless and reimbursement claims team. The incumbent will leverage their deep understanding of insurance to guide the team in navigating complex claims scenarios, ensuring optimal outcomes for our customers.Principal Accountabilities * Leadership and Guidance: Provide expertise and direction to the cashless and reimbursement claims team, drawing upon extensive insurance knowledge to enhance team performance and service delivery. * Manage the end-to-end operations for Claims: Manage daily operations for both Cashless and Reimbursement. The focus will be on daily productivity, efficiency improvement, process improvement, team adherence, and SLA adherence with partners. * Transaction Management: Oversee and monitor daily transactions related to claims processing, ensuring adherence to quality standards and operational efficiency as the claims leader. * Product improvement: Design process changes required to improve efficiency via automation, process re-engineering etc. Liaise with the Plum product team for getting these implemented. * Knowledge Sharing: Promote a culture of knowledge sharing across cross-functional teams, simplifying the payout process and educating stakeholders on claims procedures and best practices. * Error Resolution: Identify processing errors by TPA & insurer and raise them swiftly and get them fixed. Act as an advocate for customers by disputing grey area claims with insurers, utilizing a thorough knowledge of insurance terms and conditions to drive favourable outcomes. Raise disputes for decisions regarding medical understanding or terms interpretation, document gaps etc., and help the Dispute team with all relevant details. * Performance Transparency: Assist clients in understanding claims performance and service statistics regularly, enhancing transparency and trust in the claims process. * Data Analysis and Process Improvement: Engage in continuous data analysis to identify trends and inefficiencies in the claims process, implementing improvements to enhance quality, efficiency, and overall service delivery.      INTERACTIONSInternal * Endorsement team * Onboarding team * Products & Engineering * Other Claims teams * Support Inbound * Account Management      External * Insurance Companies * TPA claims processing or CRM teams      Who can apply? * 15 years of experience required in health insurance - either in an Indian or International insurer. * A minimum of 8-10 years of claims operations experience in health claims. * Bachelors degree in Business, Insurance, or a related field. * Extensive experience in Health Insurance claims management/operations, particularly in cashless and reimbursement claims. * Strong analytical skills with a proven ability to conduct detailed case analyses and data-driven decision-making. * Excellent communication and interpersonal skills, facilitating effective collaboration with internal teams and external partners. * A strong understanding of insurance policies, terms, and conditions, with experience in dispute resolution. * Proven leadership skills, with a focus on developing and motivating teams for high performance.

Plum - General Manager- Claims Operations - Plum

&lt;strong&gt;General Manager - Claims Operations Bengaluru&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;strong&gt;Customer Success 7. Customer Success / Full Time / On-site&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;strong&gt;About Plum&lt;br&gt;&lt;br&gt;&lt;/strong&gt;Plum is an employee insurance and health benefits platform focused on making health insurance simple, accessible and inclusive for modern organizations.&lt;br&gt;&lt;br&gt;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.&lt;br&gt;&lt;br&gt;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.&lt;br&gt;&lt;br&gt;&lt;strong&gt;Job Purpose&lt;br&gt;&lt;br&gt;&lt;/strong&gt;We are seeking a knowledgeable and experienced General Manager of Claims to be part of our cashless and reimbursement claims team. The incumbent will leverage their deep understanding of insurance to guide the team in navigating complex claims scenarios, ensuring optimal outcomes for our customers.&lt;br&gt;&lt;br&gt;&lt;strong&gt;Principal Accountabilities&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;Leadership and Guidance: Provide expertise and direction to the cashless and reimbursement claims team, drawing upon extensive insurance knowledge to enhance team performance and service delivery.&lt;/li&gt;&lt;li&gt;Manage the end-to-end operations for Claims: Manage daily operations for both Cashless and Reimbursement. The focus will be on daily productivity, efficiency improvement, process improvement, team adherence, and SLA adherence with partners.&lt;/li&gt;&lt;li&gt;Transaction Management: Oversee and monitor daily transactions related to claims processing, ensuring adherence to quality standards and operational efficiency as the claims leader.&lt;/li&gt;&lt;li&gt;Product improvement: Design process changes required to improve efficiency via automation, process re-engineering etc. Liaise with the Plum product team for getting these implemented.&lt;/li&gt;&lt;li&gt;Knowledge Sharing: Promote a culture of knowledge sharing across cross-functional teams, simplifying the payout process and educating stakeholders on claims procedures and best practices.&lt;/li&gt;&lt;li&gt;Error Resolution: Identify processing errors by TPA &amp;amp; insurer and raise them swiftly and get them fixed. Act as an advocate for customers by disputing grey area claims with insurers, utilizing a thorough knowledge of insurance terms and conditions to drive favourable outcomes. Raise disputes for decisions regarding medical understanding or terms interpretation, document gaps etc., and help the Dispute team with all relevant details.&lt;/li&gt;&lt;li&gt;Performance Transparency: Assist clients in understanding claims performance and service statistics regularly, enhancing transparency and trust in the claims process.&lt;/li&gt;&lt;li&gt;Data Analysis and Process Improvement: Engage in continuous data analysis to identify trends and inefficiencies in the claims process, implementing improvements to enhance quality, efficiency, and overall service delivery.&lt;br&gt;&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;&lt;strong&gt;INTERACTIONS&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;strong&gt;Internal&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;Endorsement team&lt;/li&gt;&lt;li&gt;Onboarding team&lt;/li&gt;&lt;li&gt;Products &amp;amp; Engineering&lt;/li&gt;&lt;li&gt;Other Claims teams&lt;/li&gt;&lt;li&gt;Support Inbound&lt;/li&gt;&lt;li&gt;Account Management&lt;br&gt;&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;&lt;strong&gt;External&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;Insurance Companies&lt;/li&gt;&lt;li&gt;TPA claims processing or CRM teams&lt;br&gt;&lt;br&gt;&lt;/li&gt;&lt;/ul&gt;&lt;strong&gt;Who can apply?&lt;br&gt;&lt;br&gt;&lt;/strong&gt;&lt;ul&gt;&lt;li&gt;15 years of experience required in health insurance - either in an Indian or International insurer.&lt;/li&gt;&lt;li&gt;A minimum of 8-10 years of claims operations experience in health claims.&lt;/li&gt;&lt;li&gt;Bachelors degree in Business, Insurance, or a related field.&lt;/li&gt;&lt;li&gt;Extensive experience in Health Insurance claims management/operations, particularly in cashless and reimbursement claims.&lt;/li&gt;&lt;li&gt;Strong analytical skills with a proven ability to conduct detailed case analyses and data-driven decision-making.&lt;/li&gt;&lt;li&gt;Excellent communication and interpersonal skills, facilitating effective collaboration with internal teams and external partners.&lt;/li&gt;&lt;li&gt;A strong understanding of insurance policies, terms, and conditions, with experience in dispute resolution.&lt;/li&gt;&lt;li&gt;Proven leadership skills, with a focus on developing and motivating teams for high performance.&lt;/li&gt;&lt;/ul&gt;

Plum

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