Key Responsibilities

1. Customer Interaction & Medical Guidance

- Handle inbound calls from customers requesting a second medical opinion.
- Review medical documents, reports, prescriptions, and diagnostic findings shared by customers.
- Provide transparent, accurate, and ethical medical advice to help customers understand their diagnosis and treatment options.
- Offer guidance on alternative treatments, specialist referrals, and clinical pathways when relevant.
- Maintain empathy, respect, and professionalism in all customer interactions.

2. Clinical Assessment & Documentation

- Document all customer interactions, medical assessments, and advice provided in the system.
- Summarize key clinical observations and recommendations in easytounderstand language for customers.
- Identify cases that require escalation to senior medical experts or specialized departments.
- Ensure medical records are handled with utmost confidentiality and comply with data-protection guidelines.

3. Coordination & Collaboration





- Work closely with internal teams such as Claims, Customer Support, and Medical Underwriting for medical clarification.
- Provide inputs to claims teams when a customers medical understanding may impact claim decisions.
- Coordinate with network hospitals whenever additional clinical information is required.

4. Compliance & Quality Assurance

- Ensure all guidance is aligned with medical ethics and regulatory requirements.
- Follow the insurers protocols for customer communication and documentation.
- Participate in quality audits, training sessions, and continuous medical education modules.
- Adhere to SLAs for call handling, documentation accuracy, and customer satisfaction.

Work Location:- Indore, Madhya Pradesh. Interested candidates can share their resume on [email protected] and (phone hidden)

📌 Health Claims Manager (Indore)
🏢 ICICI Lombard
📍 Indore