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.
Positive 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 chance, we would love to hear from you.

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

📌 Claims Thane
🏢 TopGear Consultants
📍 Thane