Customer Care Executive

Job role- Customer Care Executive-

Key Responsibilities:

1. Operational / Functional

• Manage high volumes of inbound and outbound calls efficiently.
• Adhere to predefined communication scripts across diverse topics.
• Provide accurate information to customers, hospitals, and branches regarding policy terms, member status, and claim status.
• Greet and engage customers professionally using approved scripts.
• Respond to telephonic and email queries promptly.
• Identify customer needs, clarify information, research issues, and offer effective solutions or alternatives.
• Build strong, sustainable customer relationships by delivering an exceptional experience.
• Maintain accurate records of all interactions in the call center database.
• Participate regularly in training programs to enhance knowledge and performance.
• Meet individual and team qualitative and quantitative targets.
• Escalate queries to team leaders when required.
• Ensure fair treatment of customers in line with regulatory and company standards.
• Handle claimrelated complaints with empathy and efficiency.
• Guide customers through claims processes, including documentation requirements.
• Provide clear explanations when a claim is not covered.

2. Complaints Management and Grievance Redressal (20%)

• Monitor and resolve regular and escalated Health Claim complaints within defined timelines.
• Coordinate with relevant stakeholders for timely escalation management and query resolution.
• Manage NPS (Net Promoter Score) data in collaboration with Underwriting, Operations, and IM teams to ensure data accuracy.
• Drive reduction in customer complaint volumes.

Educational Qualifications

• 10+2, 10+3 years full time Diploma + Graduate in any discipline (graduates preferred).
• Freshers may be considered if strong customer service skills are demonstrated.

Core Experience

• Experience in a call center or customer service function within a TPA or an inhouse setup of a general/health insurance company.
• Experience in BPO (inbound/outbound) with understanding of health insurance processes is acceptable.
• Strong verbal and written communication skills.
• Excellent listening skills and attention to detail.
• Ability to manage irate, anxious, or distressed customers with patience and empathy.
• Ability to remain composed under stressful situations.
• Flexibility to work in rotational shifts, including evenings, weekends, and public holidays.
• Willingness to work night shifts (for females, shifts between 8 AM and 8 PM only).

Preferred Knowledge / Experience

• Insurance qualification preferred.
• Knowledge of spoken languages: English, Hindi, and at least one regional language (Telugu/Tamil/Malayalam/Odia/Bengali/Gujarati).

Interested candidates kindly share resume at [email protected]