About the Role:
We are hiring Claims Processing Executives to support backend operations for health insurance TPAs and insurers. The role involves handling medical claims, pre-authorisation requests, and ensuring accurate, timely processing in line with defined SLAs.
Key Responsibilities:
- Review and process health insurance claims (cashless & reimbursement)
- Verify medical documents, bills, and policy coverage
- Handle pre-authorisation (pre-auth) requests from hospitals
- Ensure accurate data entry and documentation
- Identify discrepancies and escalate issues where required
- Maintain turnaround time (TAT) and accuracy standards
- Coordinate internally for claim resolution and updates
Required Skills:
- Solid attention to detail and process discipline
- Good English reading and comprehension
- Basic computer skills (Excel, data entry)
- Ability to follow SOPs and meet deadlines
- Problem-solving mindset
Preferred Background:
- B.Com / BBA / Life Sciences / Pharmacy / Nursing
- Experience in insurance, healthcare BPO, or hospital billing is a plus