We have exciting opportunities for the role of Senior Manager – Health Management Team
Location: Mumbai
Interested candidate can share resume
[email protected] with Senior Manager – Health Management Team subject line and share below details.
Current Salary
Expectation
Notice Period
Education (Full Time / part Time
Key Responsibilities:
• Claims Assessment: Evaluate and process health insurance claims in accordance with policy terms and conditions.
• Medical Review: Identify and flag potential cases of medical abuse or discrepancies in treatment protocols.
• Admissibility Decision: Determine claim eligibility based on thorough review of medical documentation and policy guidelines.
• Tariff Adjudication: Review and authorize cashless approvals, ensuring alignment with applicable tariffs and negotiated rates.
• Stakeholder Coordination: Liaise effectively with internal teams, network hospitals, and other external stakeholders to ensure smooth claim processing and resolution.
Qualifications & Skills:
• MBBS/BAMS/BHMS or equivalent medical qualification (preferred).
• Strong understanding of health insurance policies and medical terminology.
• Analytical mind-set with attention to detail.
• Excellent communication and decision-making skills.
• Ability to work collaboratively in a fast-paced setting.
• Flexible to work in rotational shifts
Experience Required: 1-2 years in Health Insurance Claims/Underwriting/Investigation etc.
Regards,
Saba Naik
📌 Senior Manager – Health Management Team (Mumbai)
🏢 ICICI Lombard
📍 Mumbai