Job highlights

- . Apac Region Experience candidates only . Manual Claims Adjudication experience . Non-Voice profiles
- (Exp.2-5years) Location-Coimbatore.
- Apac Region Experience candidates only

- Manual Claims Adjudication experience
- Non-Voice profiles
- Assess complex medical claims similar to AXA, AIA, Alliance Care
- Verify medical codes, diagnosis and procedure to ensure compliance with industry standards (e.g. ICD 9, ICD 10, CPT)
- Review Clinical & Day Case claims and approve/reject basis the SOP
- Review Hospital Inpatient & Outpatient Claims, analyze the vouchers/medical documents, categorize the perks as per the SOP and approve/reject basis the SOP
- Provide guidance and support to facilitate junior advisors resolve complex claims
- Identify potential fraud, waste, and abuse (FWA) Flag suspicious cases, highlight patterns, and work with compliance teams to ensure early detection and escalation

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📌 Insurance Manual Claim Adjudication professional (Bengaluru)
🏢 Han Digital Solution
📍 Bengaluru