- Handle customer calls related to health insurance claims and medical queries.
- Review the customer's disease/medical condition, diagnosis, and treatment details related to the claim.
- Verify medical prescriptions, medicines, investigation reports, and other relevant medical documents.
- In case of hospitalization, verify the hospitalization details and claim information.
- Check whether the hospital and treatment are covered/eligible as per the customer's insurance policy.
- Verify medical and claim details against policy terms and coverage requirements.
- Provide customers with appropriate medical guidance and clarification regarding treatment and claim-related queries.
- Coordinate with customers and relevant internal teams during the claim verification process.
- Handle customer interactions over the phone with clear and qualified communication.
- Maintain accurate documentation and ensure timely completion of claim verification and customer support activities.
- The role involves both customer advisory and medical/claim verification responsibilities.
Preferred candidate profile
- MBBS / BHMS qualified candidates only
- Candidates with Corporate Doctor / Clinical Support experience preferred
- Experience in Health Insurance, Medical Claims, Claims Verification or Healthcare Operations will be an advantage
- Strong verbal and written communication skills
- Good understanding of medical documents, prescriptions, diagnosis and treatment
- Comfortable handling customer calls and providing medical guidance
- Candidates willing to relocate to Indore can apply
- Comfortable working in rotational day shifts
- Candidates available to join in October 2026 preferred.