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Responsibilities

Review, analyze, make appropriate and accurate decisions on dental claims in accordance with policy and state/federal law and regulations. Analyze claim detail and apply knowledge of claims procedures, product design, contract provisions and state and federal regulations to make appropriate, accurate, and timely claim decisions. This includes having a knowledge of plan provisions, determination of eligibility, verification of data input, identification of correct benefit level, coordination of benefits, and corrections.

Qualifications

Candidates should have 1–3 years of relevant work experience, preferably in insurance, claims processing. Life Sciences graduates are preferred. The role requires robust attention to detail, high accuracy, excellent written and verbal communication skills, and the ability to use basic math to determine claim payments.



Applicants should be capable of working independently and in team environments, managing time effectively, navigating multiple technology systems, and maintaining confidentiality. The position requires comfort in a fast‑paced, production‑driven setting. Shift timings include a training schedule of 5:30 PM to 2:30 AM and regular work hours of 1:30 PM to 10:30 PM.

Additional Information

• Life Sciences graduate.
• 1–3 years of experience in claims, knowledge about medical/dental terminology or related industry courses (e.g., LOMA); prior claims processing experience preferred.
• Proficient in MS Office with strong written and verbal communication skills.

Apply on Kit Job: kitjob.in/job/44wcpa

📌 Associate Medical Reviewer (Pune)
🏢 Important Company of the Sector
📍 Pune