Claims Executive

3 days ago


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

Vidal is hiring for Claims-Executive

Work Location: 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**
- **2-3 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 - ₹25,000.00 per month

**Experience**:

- total work: 1 year (preferred)

Work Location: In person


  • Claim Executive

    2 weeks 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...

  • Claims Executive

    5 days ago


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

    Vidal is hiring for Claims-Executive/Team leader Level for Gurgaon Location. Udhyog Vihar,Sector 19 Gurgaon Job Timings: 9:30AM to 5:30PM Monday to Saturday Work from Office only 1.Claim processing-Health Insurance 2.Medical Terminology Knowledge and exp in Claim processing in 2 to 5 yrs of exp. Immediate Joiner will be preferred. **Job Types**:...


  • 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...

  • Executive- Claims

    1 week ago


    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. **Key Responsibilities**: 1.Manage...


  • 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....


  • Gurugram, Haryana, India Talent X International Full time

    **Job Role -**Group Health Insurance Claim Specialist **Location -**Gurgaon **Working Days -**6 Days **Salary -**3 - 3.5 LPA **Roles & Responsibilities -** - Review and verify group health insurance claims for accuracy, eligibility, and policy compliance. - Maintain strict adherence to TAT and SLA commitments, delivering on deadlines consistently. -...


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

    Vidal is hiring for Claims-Executive Work Location: Gurgaon **Work from Office only** **Key Responsibilities** Claim processing which includes NME evaluation Tariff applicability Policy T & c Co-pay Discount deduction Investigation criteria knowledge Insurer wise policy T&C knowledge Basic Documentation required for claim processing Experience...


  • Gurugram, Haryana, India Talent X International Full time

    **Job Types**: Full-time, Permanent Pay: ₹300,000.00 - ₹350,000.00 per year **Benefits**: - Health insurance - Leave encashment - Life insurance - Provident Fund Schedule: - Day shift Supplemental Pay: - Overtime pay - Yearly bonus **Experience**: - Health Insurance Claim: 1 year (preferred) Work Location: In person

  • Claim Processor

    1 week ago


    Gurugram, Hyderabad, Mumbai, India Career Shaper Full time ₹ 8,00,000 - ₹ 12,00,000 per year

    OPEN FOR FRESHERS BHMS AND BMS DOCTORSKnowledge of Claims processes: Indemnity (Cashless, Reimbursement), Fixed Benefit ProductsUnderstanding of Claims systems (process flow & System fields) Health, PA & TravelExperience in measurement of performance (TAT, accuracy in claims adjudication)Expectations management of the Claims teamTAT & expectations management...

  • Insurance Executive

    7 days ago


    Gurugram, Haryana, India Big Boy Toyz Ltd. Full time

    **Job Title**: Insurance Executive **Location**: Gurgaon **Employment Type**: Full-Time **LUXURY CARS -INSURANCE or Claims and Endorsements** **A luxury automobile claims insurance executive manages insurance policies specifically tailored for high-end, luxury vehicles. This role involves**: - Managing claims: Investigating claims cases, alerting...