Job Title: Assistant / Deputy Manager Claims (MBBS/BAMS/BHMS)

Location: Thane (Work from Office)

Job Description

We are hiring experienced medical professionals for a leading Health Insurance organization.

Key Responsibilities:

- Review and adjudicate Cashless and Reimbursement Health Insurance Claims.
- Perform medical assessment and claim scrutiny as per policy guidelines.
- Coordinate with hospitals, TPAs, and internal stakeholders for timely claim settlement.
- Conduct medical and technical audits to ensure claim quality and compliance.
- Maintain claim-related MIS and ensure adherence to defined TATs.
- Identify discrepancies and support claim quality and fraud prevention initiatives.
- Ensure compliance with company policies and regulatory guidelines.

Eligibility Criteria:

- MBBS / BAMS / BHMS.
- Minimum 3 years of experience in Health Insurance or TPA.




- Experience in Cashless Claims, Reimbursement Claims, Claims Adjudication, Medical Review, Claims Audit, or Pre-Authorization.
- Good analytical, communication, and MS Excel skills.
- Willing to work from the Thane office.
- Comfortable working in a roster-based workplace (including weekends with weekly Comp-Off).

Preferred Background:

Candidates currently working with Health Insurance companies or TPAs will be preferred.

If you have relevant experience in health insurance claims and are looking for a challenging opportunity, we would love to hear from you.

Interested candidates can apply with their updated resume rutujastopgearconsultants.com.

📌 Claims (Thane)
🏢 TopGear Consultants
📍 Thane