Medical Insurance Claims Processor

4 days ago

Kochi Kerala, India Doorcaz Full time

**Position Summary**

We are seeking enthusiastic MBBS freshers / interns / house-surgeons (or with up to 2 years experience) to join our medical insurance claims processing team. The role involves verifying medical documents, liaising with hospitals / TPAs / insurers, reviewing claims for accuracy and completeness, and ensuring timely processing. Clinical knowledge is helpful for assessments but the primary focus is on documentation, coding/compliance, and communication.

**Key Responsibilities**
- Review medical bills, treatment notes, diagnostic reports etc. for insurance claims.
- Verify policy coverage, exclusions, pre-authorizations.
- Liaise with TPAs / insurance companies / hospital billing departments.
- Ensure claims are accurate, with all required supporting documentation.
- Handle queries, follow-ups, denials & rejections.
- Maintain records, adhere to SLAs and turnaround times.
- Provide medical expertise in reviewing treatment plans, coding, and clinical documentation to support claim adjudication; coordinate with treating hospitals and consult directly with doctors to assess the necessity and urgency of proposed procedures.
- Assist senior processing officers / managers as needed.

**Qualifications**
- MBBS degree (fresh graduates, house-surgeons preferred).
- Good understanding of medical terminology, anatomy & common diagnostics.
- Strong communication skills (written & verbal), attention to detail.
- Basic computer skills, ability to work with spreadsheets / claim processing software.
- Ability to work in a fast-paced environment, meet deadlines, manage multiple tasks.

**What We Offer**
- Competitive salary (see below) + incentives/performance bonuses.
- Training in insurance claims norms, coding, policy review.
- Regular working hours, with occasional extended hours if needed.
- Opportunity for growth into senior processing or supervisory roles.

Pay: ₹50,000.00 - ₹100,000.00 per month

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