The Medical Helpdesk Support is responsible for reviewing and assessing medical claims from a clinical perspective to ensure treatments, diagnoses, and hospitalizations are appropriate and aligned with medical guidelines and company policies. The role supports pre-approval requests, reviews medical records and supporting documents, and works closely with hospitals and internal teams to clarify claim information and support claim decisions. The role requires strong clinical judgment, attention to detail, and the ability to interpret medical information while helping ensure a fair, accurate, and efficient claims assessment process. **Position Responsibilities:** + Review and assess medical claims (reimbursement, and cashless) from a clinical perspective. + Validate appropriateness of diagnosis, treatment, and hospitalization based on nursing and medical guidelines. + Support pre-approval (pre-authorization) processes for hospital and non-hospital cases. + Assess medical necessity, length of stay, and treatment plans. + Analyze medical records, discharge summaries, and supporting documents. + Ensure completeness and accuracy of claim documentation. + Assist in reviewing medical disputes and appeal cases. + Provide clinical input to support claim decisions. + Follow up on incomplete or unclear documentation. + Identify potential overutilization, irregular treatment patterns, or inconsistencies in claims. + Escalate complex or high-risk cases to Medical Doctor (if required). + Ensure all claim assessments are in line with company policies, clinical guidelines, and regulatory requirements. + Candidates with a medical background will be preferred. **Required Qualifications:** + Bachelor's Degree in Healthcare, Medical Sciences, Nursing, or a related field.



+ Fresh graduates or doctors with 1-2 years of clinical experience are welcome to apply. + Experience as a General Practitioner, internship doctor, or in a hospital/clinic setting is an advantage. + Positive understanding of medical diagnoses, treatment plans, and hospitalization practices. + Able to review and interpret medical records, laboratory results, and clinical documentation. + Strong analytical and problem-solving skills. + Detail-oriented with good documentation and reporting skills. + Good communication skills and ability to work with multiple stakeholders. + Proficient in Microsoft Office applications. + Interest in insurance claims, managed care, or medical case assessment is preferred. **Preferred Qualifications:** + Solid interpersonal skills to effectively build relationships and communicate with other departments **When you join our team:** + We'll empower you to learn and grow the career you want. + We'll recognize and support you in a flexible environment where well-being and inclusion are more than just words. + As part of our global team, we'll support you in shaping the future you want to see.



**マニュライフとジョン・ハンコックについて** マニュライフ・ファイナンシャル・コーポレーションは、「あなたの未来に、わかりやすさを」を提供する、国際的な大手金融サービスプロバイダーです。当社について詳しくは、 https://www.manulife.co.jp/ lをご覧ください。 **マニュライフは機会均等を是とする雇用主です** マニュライフ/ジョン・ハンコックでは、多様性を受け入れます。私たちは、サービス提供先であるお客さまと同様に、多様な人材を引きつけ、育成し、定着させ、文化や個人の力を受け入れる包括的な職場環境を促進するよう努めています。当社は公正な採用、定着、昇進、報酬に努めています。当社のすべての慣行およびプログラムは、人種、祖先、出身地、肌の色、民族的出自、市民権、宗教または宗教的信念、信条、性別（妊娠および妊娠関連の状態を含む）、性的指向、遺伝的特徴、退役軍人としての地位、性自認、性に関する表明、年齢、婚姻状況、家族状況、障害、または適用法で保護されるその他の要因に対する一切の差別を行うことなく管理されます。 雇用への平等なアクセスを提供するために、障壁を取り除くことが当社の優先事項です。人事担当者は、応募者が応募プロセス中に合理的配慮を要求する場合に協力します。配慮要求のプロセス中に共有されるすべての情報は、適用される法律およびマニュライフ/ジョン・ハンコックのポリシーに準拠した方法で保存および使用されます。申請プロセスにおいて合理的配慮を要求するには、 [email protected] までご連絡をお願いします。 **Working Arrangement** ハイブリッド勤務

📌 Medical Helpdesk Support (India)
🏢 Manulife
📍 India