Key Responsibilities:
- Process Health Claims files accurately and efficiently.
- Perform Claim Registration and Claim Adjudication as per company guidelines.
- Review claims and identify potential fraudulent activities.
- Ensure adherence to defined Service Level Agreements (SLAs) and process claims within the stipulated Turnaround Time (TAT).
- Verify claim documents and assess eligibility as per policy terms and conditions.
- Coordinate with CRM, Provider, Sales, and Grievance teams for claim-related support and resolution.
- Maintain high standards of quality, accuracy, and compliance in claim processing.
- Respond to internal and external queries related to claims in a timely manner.
- Support continuous process improvement initiatives to enhance operational efficiency.

Key Skills Required
- Health Claims Processing
- Claim Adjudication
- Claim Registration
- Fraud Detection
- Health Insurance
- Medical Claims
- SLA & TAT Management

Eligibility
- Pharm-D, B.Sc Nursing, or B.Pharmacy Freshers (with all certificates in hand).
- Any Graduate with a minimum of 2 years' experience in Health Claims Processing.

📌 Walk-in || Claims Executive (Hyderabad)
🏢 TATA AIG General Insurance Company
📍 Hyderabad