Industry: Health Insurance / Medical Claim Investigation
Location: Aliganj, Lucknow
About the Role
We are looking for B.Pharm and Nursing professionals to join our medical claim investigation team. This is a non-clinical role where candidates will use their medical knowledge to verify and assess healthcare-related information for insurance claims.
Key Responsibilities
Review and verify medical documents, prescriptions, investigation reports, bills, and hospital records.
Conduct medical claim-related verification as per assigned cases.
Coordinate with hospitals, clinics, pharmacies, patients, and other relevant parties for information verification.
Check the consistency and authenticity of medical information provided in claim documents.
Identify discrepancies, missing information, or inconsistencies in medical records.
Prepare explicit and accurate investigation reports based on findings.
Maintain proper documentation and case records.
Coordinate with the internal claims/investigation team for case updates and closures.
Maintain confidentiality of patient and claim-related information.
Eligibility
B.Pharm / B.Sc. Nursing / GNM candidates can apply.
Freshers with valuable medical knowledge are welcome.
Experience in insurance claims, TPA, hospital administration, medical coding, or medical investigation will be an advantage.
Positive communication and documentation skills.
Basic computer knowledge and ability to work with MS Office.
Strong attention to detail and analytical skills.
Important This is a non-clinical position. The role does not involve patient treatment, nursing duties, or direct clinical care.
Key Skills: Medical Documentation | Claim Verification | Healthcare Knowledge | Investigation | Report Writing | Communication | Attention to Detail