Sr. Associate OPD claim handler

4 days ago


bangalore, India ACKO Full time

About JobClaim handler working on OPD (Outpatient Department) claims,Skills & QualificationMedical backgroundHealthcare expertise Strong analytical and attention-to-detail skillsAbility to identify policy compliance issues or mismatched documentationClear and professional email communication with customers and internal teamsOwnership of cases until closure (especially when follow-up documents are pending)Responsibilities·       Understanding of OPD coverage under different policy types (corporate, retail, etc.).·       Ability to interpret policy terms, sub-limits, and exclusions related to OPD.·       Familiarity with standard treatment and diagnostic codes (ICD, CPT, or similar).·       Knowledge of claim processing workflows — from registration to adjudication and payment.·       Awareness of fraud indicators (e.g., repeated consultations, manipulated invoices, or fabricated prescriptions).Proficiency in the claim processing system



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