Medical Insurance Claims Processor

2 weeks ago

Cochin, Kerala, India Doorcaz Full time ₹ 5,00,000 - ₹ 12,00,000 per year

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.

Job Types: Full-time, Fresher

Pay: ₹50, ₹100,000.00 per month

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