Job Designation-: Insurance TPA, Claim Specialist

Roles & Responsibilities-:

- Candidates should have worked in Hospital Insurance desk (Most Important)
- Provide Medical opinion for Health Insurance Claims
- Processing of Cashless Requests & Health Insurance Claim Documents
- Proficient with medical terms & system.
- Understanding of Policy terms & conditions & Various Protocols / Guidelines
- Understanding of Claims adjudication / Claims Processing
- Maintaining & Ensuring Standard Operating Procedures & Protocols
- Ailment Wise ICD & Procedure Coding
- Manage volumes effectively & efficiently to maintain Turnaround time of processing cases
- VIP Claims Processing and TAT Maintenance
- Claim Case Management / Cost Management

Requirements-:





- At least 2-3 yrs experience in Medical Officer Claims Processing Cashless/Reimbursement cases in any hospital
- Good Excellent oral and written communication, negotiation and decision-making skills.
- Positive customer service/relationship skills and ability to work effectively in a fast-paced environment with shifting priorities.

Immediate Joiner

Job Type: Permanent

Pay: ₹18,110.25 - ₹23,862.52 per month

Benefits:

- Health insurance
- Provident Fund

Experience:

- total work: 1 year (Preferred)

Work Location: In person

📌 TPA Executive (India)
🏢 ClaimBuddy Technologies
📍 India