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Medical Claims Specialist
1 week ago
About HDFC ERGO General Insurance:
HDFC ERGO General Insurance is a leading provider of general insurance solutions in India. Our company prides itself on its commitment to delivering exceptional customer experiences and providing innovative products that cater to the evolving needs of our customers.
Job Title: Medical Claims Specialist
About the Role:
This role involves reviewing and processing medical claims, ensuring timely and accurate payments to policyholders. The successful candidate will have strong analytical skills, attention to detail, and excellent communication abilities to work closely with internal stakeholders and external partners.
Key Responsibilities:
- Minimum experience of 3 years in health insurance claims processing specifically cashless and hospital payment claims.
- Strong understanding of health insurance processing terminologies, concepts, and guidelines.
- Skills for using moderate proficiency level MS Excel/Word.
- Preferred experience in audit/QC of claims, ability to identify reasonable/un-reasonable expenses of bills in relation to T&Cs applicable.
- Good knowledge of hospital billing patterns, and understanding of claims adjudication for payment.
- Maintain productivity reports, and good communication skills.
- Agile ability to adapt as per business needs/process dynamics.
Location: Noida-2 (Sector 62) - work from office.
Qualification: Medico (BHMS/BAMS) for hospital provider payment claims including cashless.
