Experience: 1–2 Years
Industry: TPA / Health Insurance
Qualification: BHMS / BAMS / BDS
Key Responsibilities
- Handle cashless & reimbursement health insurance claims.
- Review medical documents, diagnosis, treatment and hospital records.
- Assess claim admissibility as per policy terms.
- Coordinate with hospitals, doctors, insurers and internal teams.
- Identify discrepancies and potential fraud indicators.
- Provide medical opinions for claim processing and escalations.
- Ensure claims are processed within defined TAT.
- Maintain accurate medical assessment records.
- Attend and participate in GoToMeeting/online meetings as required.
Requirements
- 1–2 years of TPA experience is mandatory.
- Good knowledge of health insurance & TPA claim processes.
- Strong medical assessment and analytical skills.
- Good communication and coordination skills.
- Basic knowledge of MS Office/Excel.
- Comfortable attending GoToMeeting/virtual meetings.
Pay: ₹30,000.00 - ₹40,000.00 per month
Benefits:
Work Location: In person
