Description
Course Name: Certificate in Health Insurance Helpdesk Operations
Course Id: CHIHO/Q0101.
Eligibility: 10+2 (Higher Secondary) or equivalent is required.
Objective: The detailed objectives are to prepare competent Health Insurance Helpdesk Executives. Participants will gain a comprehensive understanding of the health insurance ecosystem, including different types of policies, terms, and the claims process. The curriculum emphasizes effective communication to handle diverse customer queries regarding policy coverage, renewals, and cashless and reimbursement claims.
Duration: Three Months.
How to Enroll and Get Certified in Your Chosen Course:
Step 1: Choose the course you wish to get certified in.
Step 2: Click on the “Enroll Now” button.
Step 3: Proceed with the enrollment process.
Step 4: Enter your billing details and continue to course fee payment.
Step 5: You will be redirected to the payment gateway. Pay the course and exam fee using one of the following methods:
Debit/Credit Card, Wallet, Paytm, Net Banking, UPI, or Google Pay.
Step 6: After successful payment, you will receive your study material login ID and password via email within 48 hours of fee payment.
Step 7: Once you complete the course, take the online examination.
Step 8: Upon passing the examination, you will receive:
• A soft copy (scanned) of your certificate via email within 7 days of examination.
• A hard copy (original with official seal and signature) sent to your address within 45 day of declaration of result.
Step 9: After certification, you will be offered job opportunities aligned with your area of interest.
Online Examination Detail:
Duration- 60 minutes.
No. of Questions- 30. (Multiple Choice Questions).
Maximum Marks- 100, Passing Marks- 40%.
There is no negative marking in this module.
| Marking System: | ||||||
| S.No. | No. of Questions | Marks Each Question | Total Marks | |||
| 1 | 10 | 5 | 50 | |||
| 2 | 5 | 4 | 20 | |||
| 3 | 5 | 3 | 15 | |||
| 4 | 5 | 2 | 10 | |||
| 5 | 5 | 1 | 5 | |||
| 30 | 100 | |||||
| How Students will be Graded: | ||||||
| S.No. | Marks | Grade | ||||
| 1 | 91-100 | O (Outstanding) | ||||
| 2 | 81-90 | A+ (Excellent) | ||||
| 3 | 71-80 | A (Very Good) | ||||
| 4 | 61-70 | B (Good) | ||||
| 5 | 51-60 | C (Average) | ||||
| 6 | 40-50 | P (Pass) | ||||
| 7 | 0-40 | F (Fail) | ||||
Key Benefits of Certification- Earning a professional certification not only validates your skills but also enhances your employability. Here are the major benefits you gain:
Practical, Job-Ready Skills – Our certifications are designed to equip you with real-world, hands-on skills that match current industry demands — helping you become employment-ready from day one.
Lifetime Validity – Your certification is valid for a lifetime — no renewals or expirations. It serves as a permanent proof of your skills and training.
Lifetime Certificate Verification – Employers and institutions can verify your certification anytime through a secure and reliable verification system — adding credibility to your qualifications.
Industry-Aligned Certification –All certifications are developed in consultation with industry experts to ensure that what you learn is current, relevant, and aligned with market needs.
Preferred by Employers – Candidates from ISO-certified institutes are often prioritized by recruiters due to their exposure to standardized, high-quality training.
Free Job Assistance Based on Your Career Interests – Receive personalized job assistance and career guidance in your preferred domain, helping you land the right role faster.
Syllabus:
Module 1: Foundations of Health Insurance Introduction to health insurance, Types of health insurance plans (individual, family floater), Key insurance terms (premium, deductible, co-pay, sum insured), Understanding network and non-network hospitals, The role of a TPA (Third Party Administrator), Claim process overview, Policy documents and their importance, Regulatory bodies (IRDAI), Health insurance products in India, Ethical conduct and professionalism.
Module 2: The Health Insurance Helpdesk Role Roles and responsibilities of a helpdesk executive, Customer service excellence, Effective communication skills (verbal, written), Handling inbound calls and emails, Query management and resolution, Building rapport with customers, Multilingual support, Documentation of customer interactions, Professional phone etiquette, Managing customer expectations.
Module 3: Policy, Claims, and Pre-Authorization Policy issuance and renewal process, Understanding policy benefits and exclusions, The pre-authorization process, Cashless and reimbursement claims, Documents required for claims, Claim intimation and registration, Claim status tracking and updates, Handling claim denials and appeals, Portability of health insurance, Endorsements and policy modifications.
Module 4: Grievance Redressal and Compliance Grievance handling procedures, Escalation matrix, Insurance Ombudsman and its role, Consumer protection laws, Privacy and data security (HIPAA principles), Fraud detection and prevention, Auditing and quality control, Compliance with IRDAI regulations, Maintaining a complaints database, Communication with internal teams.
Module 5: Technology and Systems Introduction to health insurance software, Customer relationship management (CRM) systems, Knowledge management tools, E-portals and mobile applications, Using a call center management system, Data entry and accuracy, Reporting and analytics basics, Troubleshooting common technical issues, Digital claim processing, Cybersecurity for customer data.
Module 6: Advanced Skills and Career Development Analyzing customer feedback and surveys, Developing a personal improvement plan, Teamwork and collaboration, Leadership skills for helpdesk supervisors, Product knowledge updates, Continuing professional development, Career paths in the insurance sector, Resume writing and interview skills, Case study analysis of complex queries, Final project: a detailed report on a customer service scenario.
Job Opportunities in Certificate in Health Insurance Helpdesk Operations
Professionals provide customer support for health insurance queries, process claims, assist with policy information, and manage KYC or verification tasks across insurance companies, TPAs, and healthcare BPOs.
Top Roles: Health Insurance Executive, Helpdesk Executive, Insurance Coordinator, Customer Support Executive – Health Insurance, Medi Assist Helpdesk Executive, Claims Support Specialist
Key Skills: Health insurance policies, claim processing, customer service, KYC/document verification, policy coordination, inbound/outbound support, escalation management, BPO operations
Salary Range (India):
- Entry Level: ₹1.2–2.5 LPA
- Mid Level / Experienced: ₹2.5–4.5 LPA (metros & private insurers up to ₹5–6 LPA)
- Specialized / Top Performers: ₹4–5 LPA+
Industries: Health Insurance Companies, Third-Party Administrators (TPAs), Healthcare BPOs, Insurance Service Providers, Policy Administration Firms
Scope: Career progression includes Helpdesk Executive → Insurance Coordinator → Customer Support / Claims Specialist → Supervisor / Team Lead → Senior Claims or Policy Management Roles, offering higher responsibility, specialization, and salary growth in health insurance operations.
