Responsibilities
Professionals in this group focus on processing insurance claims.
They validate members, provider and other claims information.
Professionals determine accurate payment criteria for clearing pending claims based on defined policy and procedure.
They maintain productivity goals, quality standards and aging timeframes and scrutinize medical claim documents and settlements.
They are involved in settlement of disputes and preparing case recovery through negotiations with the third party and providers.
Specialists in this group work as fully contributed team member under broad supervision.
They further build up on domain expertise along with technical skills.




They work on complex projects which are not similar or routine based using standard concepts and principles using their knowledge and judgement.
They require a qualified degree along with many years of work experience and are responsible for coaching/mentoring junior team members.

Qualifications
Typically requires a University Degree or equivalent experience and minimum 5 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.

📌 Sr Analyst Claims Specialist Mumbai (India)
🏢 Artex Risk Solutions
📍 India