Claims Examiner

2 days ago

Mumbai, Maharashtra, India beBeeInsurance Full time ₹ 9,00,000 - ₹ 12,00,000
Job Overview

This position is responsible for reviewing and auditing closed files to ensure accuracy and compliance. The ideal candidate will have in-depth knowledge of medical cases, including policy coverages for OPD, hospitalization, personal accident, and travel claims.

Candidate Requirements
  • Proven experience in audit with a strong analytical mindset.
  • Excellent communication and negotiation skills.
  • Familiarity with basic Microsoft Excel and regulatory changes.
  • Minimum 7 years of experience in general insurance Accident & Health claims.
Preferred Qualifications
  • Degree in medicine (BHMS/BAMS/MBBS).
Responsibilities
  • Review and audit closed files for accuracy and compliance.
  • Handle open file reviews for third-party administrators and in-house claims.
  • Recoveries from third-party administrators for claims processed with errors.
  • Highlight areas of improvement.
  • Prepare and publish monthly reports.

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