- Manage claims from receipt to settlement, ensuring timely and accurate processing.
- Conduct thorough analysis of medical records, bills, and other relevant documents to determine claim validity.
- Coordinate with healthcare providers, insurance companies, and patients to resolve claim-related issues.
- Ensure compliance with regulatory requirements and industry standards for claims adjudication.
- Maintain accurate records of all interactions related to claims management.
Desired Candidate Profile
- 1-6 years of experience in TPA (Third Party Administrator).
- BAMS/BUMS/BHMS qualified doctors with registration required.
- Solid understanding of health care services, claims processing, and claims management principles.
- Proficiency in handling multiple tasks simultaneously while maintaining attention to detail.
📌 Medical Officer (Pune)
🏢 Family Health Plan (FHPL)
📍 Pune
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