We're Hiring | Senior Health Claims Adjudicator
Location: Thane, Maharashtra
Company: Synergix Services Private Limited
Are you an experienced Health Claims Professional with expertise in adjudicating complex medical claims? We are looking for a Senior Health Claims Adjudicator to join our growing team and play a key role in delivering accurate, timely, and high-quality health claims processing.
Key Responsibilities: ✔ Adjudicate complex local and overseas health claims, including hospitalization, surgery, radiation, and specialty services.
✔ Ensure claims are processed within established turnaround times.
✔ Interpret policy benefits and verify eligibility accurately.
✔ Coordinate with healthcare providers to obtain required medical documentation.
✔ Respond promptly to member and provider claim-related queries.
✔ Support provider payment processing, audits, and fraud detection initiatives.
✔ Provide technical support for provider portal submissions.
✔ Maintain compliance with company policies, regulatory requirements, and quality standards.
✔ Contribute to process improvement initiatives and special projects.
Requirements: ✅ Bachelor's Degree in Applied Sciences or a related discipline (preferred).




✅ Minimum 3+ years of experience in Health Claims Adjudication or a similar role.
✅ ACS, FLMI, and FLHC designations required.
✅ Certified Medical Coding credentials required.
✅ Strong analytical and mathematical aptitude.
✅ Ability to interpret insurance policies and medical documentation.
✅ Proficiency in Microsoft Office applications.
✅ Excellent communication, organizational, and problem-solving skills.
What We're Looking For: Strong attention to detail and accuracy.
Ability to manage multiple priorities in a fast-paced environment.
High level of customer service and professionalism.
Self-motivated with excellent decision-making skills.
Commitment to confidentiality, quality, and continuous improvement.
Interested candidates are invited to share their updated resume at: [email protected]
Know someone who would be a excellent fit? Feel free to tag them or share this chance within your network.
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📌 Senior Health Claims Adjudicator (Thane)
🏢 Synergix Services Private
📍 Thane