Tpa Insurance Operations

5 days ago

Baner Pune Maharashtra, India ClaimBuddy Technologies Full time

**Job Designation-: Insurance TPA, Medical Officer/ Claim Specialist**

**Roles & Responsibilities-**:

- Provide Medical opinion for Health Insurance Claims
- Processing of Cashless Requests & Health Insurance Claim Documents
- Proficient with medical terms & system.
- Understanding of Policy terms & conditions & Various Protocols / Guidelines
- Understanding of Claims adjudication / Claims Processing
- Maintaining & Ensuring Standard Operating Procedures & Protocols
- Ailment Wise ICD & Procedure Coding
- Manage volumes effectively & efficiently to maintain Turnaround time of processing cases
- VIP Claims Processing and TAT Maintenance
- Claim Case Management / Cost Management

**Requirements-**:

- At least 2-3 yrs experience in Medical Officer Claims Processing Cashless/Reimbursement cases in any hospital
- Good Excellent oral and written communication, negotiation and decision-making skills.
- Good customer service/relationship skills and ability to work effectively in a fast-paced environment with shifting priorities.

Immediate Joiner

**Salary**: ₹15,086.00 - ₹25,412.00 per month

**Benefits**:

- Cell phone reimbursement
- Health insurance
- Life insurance
- Provident Fund

Schedule:

- Day shift

Supplemental pay types:

- Yearly bonus

Ability to commute/relocate:

- Hosur, Tamil Nadu, Hosur - 635109, Tamil Nadu: Reliably commute or planning to relocate before starting work (preferred)

**Experience**:

- total work: 1 year (preferred)

**Speak with the employer**

+91-XXXXXXXXXX

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