Responsibilities:
- Processing insurance claims.
- Validate members, provider and other claims information.
- Determine accurate payment criteria for clearing pending claims based on defined policy and procedure.
- Maintain productivity goals, quality standards and aging timeframes and scrutinize medical claim documents and settlements.
- Involved in settlement of disputes and preparing case recovery through negotiations with the third party and providers.
- Work as subject matter experts (SMEs).
- Complete diverse complex/non-standard tasks in area of responsibility.
- Understand and act on complex situations, and adapt work to business goals.
- Operate with wide latitude for making independent decisions/recommendations, which typically have financial, operational, legal,



or image/reputation impact.
- Assist junior team members with work related to standard issues/queries.
- Possess working knowledge of one functional area/sub process.

Qualifications:

Typically requires a University Degree or equivalent experience and minimum 7 years of prior relevant experience.

Disclaimer : This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.

📌 Assistant Manager (Pune)
🏢 Artex Risk Solutions
📍 Pune