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