Claims Processing Executive

1 day ago

Gurugram Haryana, India Vidal Health Insurance TPA Private Limited Full time

Vidal is hiring for Claims-Executive/Team leader Level

**Gurgaon Location.**

**Udhyog Vihar,Sector 19 Gurgaon**

**Work from Office only**

**Key Responsibilities**

**Claim Review & Validation**
- Examine submitted claims for completeness and accuracy
- Verify policy coverage and eligibility
- Identify discrepancies or missing documentation

**Claims Processing**
- Enter and adjudicate claims in the system (cashless & reimbursement)
- Calculate payable amounts as per policy terms
- Ensure timely processing within defined SLAs

**Stakeholder Communication**
- Liaise with policyholders, hospitals, and insurers for claim clarifications
- Respond to queries and provide claim status updates
- Coordinate with Preauth and Customer Care teams

**Documentation & Compliance**
- Maintain detailed records of claims and actions taken
- Ensure adherence to IRDAI guidelines and internal SOPs
- Flag potential fraud or irregularities for investigation

**Reporting & Analysis**
- Generate daily/weekly/monthly claim reports
- Track claim trends and highlight recurring issues
- Support audits and internal reviews with accurate data

**Skills & Competencies**
- Strong attention to detail and data accuracy
- Familiarity with medical terminology, ICD/CPT codes
- Proficiency in claims software (Portal)
- Effective communication and problem-solving skills
- Ability to manage sensitive information with discretion

**Experience Required**
- **1-3 years** of experience in **claims processing** within the **TPA or Health Insurance** domain
- Exposure to group health policies and coordination with hospitals or corporate clients is preferred

**Job Types**: Full-time, Permanent

Pay: ₹22,000.00 - ₹28,000.00 per month

**Experience**:

- total work: 1 year (preferred)

Work Location: In person

  • Claim Processing Executive

    2 days ago

    Gurugram, Haryana, India INK IT SOLUTIONS Full time

    We're looking for Claim Processing Associate (US Process) for Gurgaon location. Exp level: - 06 Months to 2 yrs POSITION OVERVIEW : Disability Management Claim Processor POSITION GENERAL DUTIES AND TASKS : *Handle claims related to disability management. *Determining customer - s disability coverage and verifying the information available in the system....

  • Claim Executive

    1 day ago

    Gurugram, Haryana, India GENUS DEPARTMENTAL STORE Full time

    **Job description**: **Claims Executive Responsibilities**: - Advice policyholders on claim procedure - Ensure fair settlement of a claim with TAT - Manage all administration aspects of the claim - Adhere to legal requirements, industry regulations and customer quality standards set by the company. - Handle any complaints associated with a claim. **Claims...

  • Executive- Claims

    5 days ago

    Ramgarh, Gurugram, Haryana, India AegisCovenant Full time

    **About Us**: AegisCovenant is a fast-growing InsureTech company founded in 2020, specializing in two-wheeler insurance management and roadside assistance (RSA). We are committed to transforming the industry with innovative technology, simplifying processes, and delivering exceptional service to our dealers and partners. **Job Overview**: We are looking for...

  • Process Associate

    5 days ago

    Gurugram, Haryana, India Genpact Full time

    _Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose - the relentless pursuit of a world that works better for people - we...

  • Process Associate

    5 days ago

    Gurugram, Haryana, India Genpact Full time

    _Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose - the relentless pursuit of a world that works better for people - we...

  • Process Associate

    2 days ago

    Gurugram, Haryana, India Genpact Full time

    Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose - the relentless pursuit of a world that works better for people - we...

  • Claims Officer

    4 days ago

    Gurugram, Haryana, India GENUS DEPARTMENTAL STORE Full time

    **Job description**: **Claims Executive Responsibilities**: - Advice policyholders on claim procedure - Ensure fair settlement of a claim with TAT - Manage all administration aspects of the claim - Adhere to legal requirements, industry regulations and customer quality standards set by the company. - Handle any complaints associated with a claim. **Claims...

  • Medical Claim Executive

    4 days ago

    Gurugram, Haryana, India GENUS DEPARTMENTAL STORE Full time

    **Job Types**: Full-time, Permanent Pay: ₹18,000.00 - ₹28,000.00 per month **Benefits**: - Leave encashment - Paid sick time - Provident Fund Schedule: - Day shift - Monday to Friday - Morning shift Supplemental Pay: - Performance bonus **Experience**: - Claim Executive: 4 years (required) - Medical Insurance Claim: 2 years...

  • Process Associate, Insurance Claims

    5 days ago

    Gurugram, Haryana, India Genpact Full time

    _Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose - the relentless pursuit of a world that works better for people - we...

  • Process Associate, Insurance Claims

    1 day ago

    Gurugram, Haryana, India Genpact Full time

    Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose - the relentless pursuit of a world that works better for people - we...