Insurance Claim Processing Manager

1 day ago


Mumbai, Maharashtra, India Impact Guru Technology Ventures Pvt Ltd Full time

About the Company:

CarePal Group is transforming healthcare financing in India by providing cutting-edge solutions that make critical and elective treatments more accessible and affordable.

Job Summary:

The AVP of Operations - Trust & Safety will drive CarePal Group's trust and safety strategy, overseeing hospital coordination, insurance claim processing, and TPA (Third-Party Administrator) operations.

Key Responsibilities:

  • Manage relationships with hospital billing departments to ensure seamless service coordination.
  • Oversee admission, discharge, and cost verification processes, ensuring adherence to CarePal's pricing agreements.
  • Lead efforts to streamline billing accuracy, end-to-end claim processing, optimize reconciliation processes, and enhance the patient experience.

Requirements:

  • Bachelor's degree in healthcare management, business administration, or a related field. MBA or equivalent advanced degree preferred.
  • 10+ years of experience in Health Insurance, claim processing, with a focus on TPA management, hospital coordination, and billing.
  • Demonstrated success in managing healthcare insurance claims, billing verification, and trust and safety protocols.

What We Offer:

  • A competitive salary package.
  • Opportunities for professional growth and development.
  • A dynamic and supportive work environment.


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