We are looking for a Senior Analyst – Health Insurance Claims to handle insurance claim processing, validation, settlement, and recovery activities while maintaining quality and productivity standards.
Key Responsibilities
- Process and validate health insurance claims.
- Verify member, provider, and claim information.
- Determine accurate payment criteria for pending claims.
- Review medical claim documents and settlements.
- Maintain productivity, quality, and claim-aging targets.
- Handle claim disputes and recovery activities.
- Coordinate and negotiate with third parties and providers when required.
- Work on complex and non-routine claims/projects.
- Apply professional knowledge and judgment to resolve issues.
- Support coaching and mentoring of junior team members.
Required Skills
- Health Insurance / Claims domain knowledge.
- Robust analytical and problem-solving skills.
- Good written and verbal communication.
- Attention to detail and accuracy.
- Ability to meet productivity and quality targets.
- Strong ownership and decision-making skills.
- Ability to handle complex claims independently.
Eligibility
- Bachelor's / Professional degree required.
- 3 to 5 years of experience in Insurance / Health Insurance Claims.
- Insurance certification is an added advantage.
- Claims processing, adjudication, settlement, or recovery experience preferred.
- Experience in coaching/mentoring junior team members is an advantage.
Apply Now if you have relevant Health Insurance Claims experience. Pay: ₹500,000.00 - ₹1,000,000.00 per year
Benefits
- Commuter assistance
- Leave encashment
- Paid time off
- Provident Fund
- Work from home
Work Location: Hybrid remote in Mumbai, Maharashtra