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Claims lead-A&H
ConfidentialMumbai6 days ago
Job descriptionIn-depth knowledge of medical cases with exposure to ailment treatments, policy coverages for OPD, hospitalization, personal accident, and travel claims. Good interpersonal skills. Must be proactive and an effective learner. Previous experience in audit. Good analytical, communication, and negotiation skills. Familiarity with basic Microsoft Excel and regulatory changes. Minimum 7 years of experience in general insurance Accident & Health claims. Degree in medicine (BHMS / BAMS / MBBS).
Role
- Closed file review and audit.
- Handling closed and open file reviews for third-party administrators and in-house claims.
- Recoveries from third-party administrators for claims processed with errors.
- Highlight areas of improvement.
- Prepare and publish monthly reports.
Candidate Must Have
Qualifications
Skills Required
Closed file review, Claims audit, Third-party administrator management, Claims recoveries, Medical case knowledge, Ailment treatments
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