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.
Solid ownership and decision-making skills.
Ability to handle complex claims independently.
Eligibility
Bachelor's / Skilled 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