Tpa Executive

2 weeks ago


Chembur Mumbai Maharashtra, India ClaimBuddy Technologies Pvt Ltd Full time

**Job Designation-: Insurance TPA, 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

**Job Type**: Permanent

Pay: ₹18,110.25 - ₹24,862.52 per month

**Benefits**:

- Health insurance
- Provident Fund

**Experience**:

- total work: 1 year (preferred)

Work Location: In person



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