Experience: 1–2 Years
Industry: TPA / Health Insurance
Qualification: BHMS / BAMS / BDS

Key Responsibilities
Handle cashless & reimbursement health insurance claims.
Review medical documents, diagnosis, treatment and hospital records.
Assess claim admissibility as per policy terms.
Coordinate with hospitals, doctors, insurers and internal teams.
Identify discrepancies and potential fraud indicators.
Provide medical opinions for claim processing and escalations.
Ensure claims are processed within defined TAT.
Maintain accurate medical assessment records.
Attend and participate in GoToMeeting/online meetings as required.

Requirements
1–2 years of TPA experience is mandatory.
Positive knowledge of health insurance & TPA claim processes.
Strong medical assessment and analytical skills.
Positive communication and coordination skills.
Basic knowledge of MS Office/Excel.
Comfortable attending GoToMeeting/virtual meetings.

Pay: ₹35,000.00 - ₹45,000.00 per month

Advantages:
Health insurance

Work Location: In person

📌 Medical Officer Mumbai City
🏢 Health Assist Insurance TPA
📍 Mumbai