Health Claims Assessor

12 hours ago


Pune, Maharashtra, India Bajaj Allianz Life Insurance Full time ₹ 9,00,000 - ₹ 12,00,000 per year

Executive Health Claims Assessment

Description
  • Claim registration – On Daily Basis need to register the claims which has been assigned for processing , Scrutiny of the documents
  • Reserve Setting :- Need to do the proper reserve setting on system based on the claim documents
  • Technical processing claims which has been assigned for processing for health/ personal accident etc claims and deductions of Non-Medical charges, Standard deductions of co-payment as per the policy terms and conditions – On Daily basis need to do technical Assessment of the claims post registration of the claim which include billing of the claim as per the respective heads, Data Entry as per the standard fields in system, Deductions of non-Medical Charges as per the standard IRDAI list, Co-Payment deductions as per the policy terms and condition/ Benefit charts etc.
  • Co-ordination with Branch Offices/Clients/Hospitals for requirements – Need to have follow up with branches office/clients/hospitals for additional documents whenever require
  • NEFT Updation – Updation of customer/insured NEFT details on system while processing the claims
  • Travelling/Relocation – Candidate should be open for travelling whenever require for official work and also ready to relocate based on the organization or business requirement.
Skills Required

Should have fair knowledge of health insurance and have fair knowledge of health Products and Personal Accident products
•Good Communication Skill –Read, Write and Speaking Good Knowledge of MS Office/Excel/Power point

Education/Qualification

MBBS , BAMS, BHMS

Desirable Skills

None


  • IVDR Assessor

    6 days ago


    Pune, Maharashtra, India DNV Full time ₹ 20,00,000 - ₹ 25,00,000 per year

    About UsWe are the independent expert in assurance and risk management. Driven by our purpose, to safeguard life, property, and the environment, we empower our customers and their stakeholders with facts and reliable insights so that critical decisions can be made with confidence.As a trusted voice for many of the world's most successful organizations, we...


  • Pune, Maharashtra, India Loop Health Full time

    We are looking for a Dedicated Claims Specialist with a strong background in medical and health insurance particularly in group medical corporate policies The ideal candidate should have 2-4 years of experience in claims processing or CRM roles Key Responsibilities Handle end-to-end processing of reimbursement claims for group medical corporate policies ...


  • Pune, Maharashtra, India Loop Health Full time ₹ 4,00,000 - ₹ 6,00,000 per year

    About the RoleWe are looking for a full-time in office member, who will look after all documentation work when it comes to Claims department. As a Claims Executive, you should have attention to details and be up to date with all the documents that are to be procured.What you will be doing:Receive Claim Files and add file details as per Loop's internal...

  • Claims Manager

    6 days ago


    Pune, Maharashtra, India Let's Secure Insurance Brokers Pvt. Ltd. Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    We're looking for a dynamic Claims Manager to handle end-to-end claims across health, motor, property, and 'll be the bridge between clients, insurers, TPAs, and internal teams ensuring smooth, timely settlements and top-notch service.


  • Pune, Maharashtra, India Danfoss Full time ₹ 2,50,000 - ₹ 5,00,000 per year

    Requisition ID:46000Job Location(s):Pune, INEmployment Type:Full TimeSegment:Danfoss Power Solutions SegmentJob Function:Quality and Environment, Health and Safety (EHS)Work Location Type:On-siteThe Impact You'll MakeAs our Claims Administrative Specialist, you'll play a key role in delivering great customer experiences by being the first point of contact...


  • Pune, Maharashtra, India Valorcrest Solutions Full time ₹ 2,00,000 - ₹ 12,00,000 per year

    Role & responsibilitiesThe Underwriter is responsible for evaluating and analysing the risks involved in Health insurance proposals-Group Mediclaim; Group Personal Accident; Workmen Compensation; Group Term Insurance etc.They ensure sound underwriting practices while working closely with insurers and clients tosecure optimal coverage and terms.Key...

  • Product Owner

    4 weeks ago


    Pune, Maharashtra, India Evolent Health Full time

    Your Future Evolves HereEvolent Health has a bold mission to change the health of the nation by changing the way health care is delivered Our pursuit of this mission is the driving force that brings us to work each day We believe in embracing new ideas challenging ourselves and failing forward We respect and celebrate individual talents and team wins We...

  • Data Engineer

    5 days ago


    Pune, Maharashtra, India Fold Health Full time ₹ 12,00,000 - ₹ 24,00,000 per year

    Job Title: Data EngineerExperience:5+ YearsLocation:Pune (Amar Tech Park, Balewadi, Pune), Full-time, In-officeDomain:Healthcare is must (Preferred - Value-Based Care / Population Health)About Fold HealthFold Health is building an AI-powered healthcare technology platform designed to support Value-Based Care (VBC) programs. By combining advanced data...

  • Salesperson

    2 days ago


    Pune, Maharashtra, India Health Insurance Care Full time ₹ 1,20,000 - ₹ 3,60,000 per year

    Company DescriptionCare health Insurance, one of the most trusted life insurance companies in India, was incorporated in 2011 and registered with IRDAI in Aug 2012. The company serves millions of families with diverse products including Protection, Pension, Savings, and Health solutions. Emphasizing a 'Customer-First' approach, SBI Life maintains high...

  • TPA Coordinator

    3 days ago


    Pune, Maharashtra, India Watchyourhealth Full time ₹ 2,16,000 - ₹ 2,64,000 per year

    Job Description :• CRM implants for claim support at client location• Resolve customer queries on policy coverage and health claim processes• Facilitate to drive claims app for submission and tracking of claims by employees• Respond to employee calls and emails as a direct SPOC allocated to specific corporate• Collect and dispatch claim documents...