12 Aug
|
Magma General Insurance
|
Mumbai
12 Aug
Magma General Insurance
Mumbai
About the Company Claim Assessment &
- Processing: Evaluate claims (cashless/reimbursement) as per policy terms, medical documents, and regulatory guidelines, ensuring accurate adjudication.
About the Role Coordination &
- Communication: Liaise with TPAs and internal teams; issue queries, approvals, and repudiation communications in a timely to TPA &
- Customer.
Responsibilities Compliance &
- Documentation: Ensure adherence to SOPs, IRDAI norms, and maintain complete audit-ready documentation with proper record of all claim actions. Quality &
- TAT Management: Process claims within defined turnaround time as per regulatory & internal guidelines while maintaining high accuracy and minimizing errors or rework.
Issue
Resolution &
- Escalation Handling: Address discrepancies, investigate suspicious cases, and escalate critical matters promptly to ensure effective resolution.
Qualifications BHMS
- MBBS
📌 Manager - Health Claims (Mumbai)
🏢 Magma General Insurance
📍 Mumbai