Role & responsibilities

- Adjudicate medical claims across both Cashless and Reimbursement channels as per policy terms and conditions.

- Review and validate claim documents to determine admissibility and liability.

- Assess and determine accurate claim payouts.

- Ensure compliance with internal guidelines, underwriting norms, and regulatory requirements.

- Coordinate with hospitals/service providers, and internal stakeholders for claim resolution.

- Identify discrepancies, red flags, and suspected fraudulent claims, and escalate as required.

- Maintain high accuracy and quality standards in claim assessment and decision-making.

- Support audits, compliance reviews, and management reporting related to claims.

- Drive customer satisfaction through timely claim processing and effective query resolution.

Preferred candidate profile

- Graduation is mandatory

- Must have minimum 2 years of health claims processing experience

- Freshers are not eligible for this role

- Must be okay with work shift on roster basis and adaptable week-offs

📌 Walk-in || Manager - Health Claims (Non-medical) (Noida)
🏢 TATA AIG General Insurance Company
📍 Noida