COMPANY DESCRIPTION:www.claimbuddy.in ClaimBuddy.in is a MediClaim support company that acts as one-stop solution for claim assistance for Patients and Hospitals. We are building an ecosystem to ensure hassle-free insurance claims by leveraging technology and a set of simple yet powerful processes and operations. Job Description: Claim Processing Doctor Position Overview: As a Claim Processing Doctor in the insurance industry, your primary responsibility is to assess and evaluate medical claims submitted by policyholders or healthcare providers. You will ensure that claims are processed accurately and efficiently according to established guidelines and policies. This role requires a strong understanding of medical terminology, procedures, and billing practices, as well as the ability to make informed decisions based on medical necessity and policy coverage. Key Responsibilities: 1. Review and Assessment: o Evaluate medical claims to determine the validity, accuracy, and completeness of information provided. o Assess medical necessity based on policy guidelines and medical evidence. o Verify the authenticity of medical documentation and reports submitted with claims. 2. Documentation and Record Keeping: o Document findings, decisions, and actions taken during claim processing. o Maintain detailed records of each claim reviewed, including correspondence and additional information obtained. o Ensure compliance with regulatory requirements and internal policies regarding confidentiality and data protection. 3. Communication and Collaboration: o Communicate with policy holders, healthcare providers, and internal stakeholders regarding claim decisions and requirements. o Provide guidance and assistance to colleagues regarding medical terminology, coding, and procedural guidelines. 4. Quality Assurance: o Conduct quality reviews of processed claims to ensure accuracy and consistency. Required Qualifications: Medical degree (MBBS/BAMS/BHMS/BUMS) from an accredited institution. Active medical license in the relevant jurisdiction. Knowledge of medical coding systems (e.g.,ICD-10, CPT)and healthcare billing practices. Attention to detail and accuracy in processing claims. Preferred Qualifications: Experience in medical claims review or healthcare administration. Familiarity with insurance industry software and claim processing systems. Strong analytical and decision-making skills. Excellent communication and interpersonal skills. Ability to work independently part of a team. Attention to detail and accuracy in processing claims. Job Type: Full-time Pay: ₹31,500.00 - ₹65,512.07 per month Benefits: Health insurance Provident Fund Work Location: In person
COMPANY DESCRIPTION:www.claimbuddy.in ClaimBuddy.in is a MediClaim support company that acts as one-stop solution for claim assistance for Patients and Hospitals. We are building an ecosystem to ensure hassle-free insurance claims by leveraging technology and a set of simple yet powerful processes and operations. Job Description: Claim Processing Doctor Position Overview: As a Claim Processing Doctor in the insurance industry, your primary responsibility is to assess and evaluate medical claims submitted by policyholders or healthcare providers. You will ensure that claims are processed accurately and efficiently according to established guidelines and policies. This role requires a strong understanding of medical terminology, procedures, and billing practices, as well as the ability to make informed decisions based on medical necessity and policy coverage. Key Responsibilities: 1. Review and Assessment: o Evaluate medical claims to determine the validity, accuracy, and completeness of information provided. o Assess medical necessity based on policy guidelines and medical evidence. o Verify the authenticity of medical documentation and reports submitted with claims. 2. Documentation and Record Keeping: o Document findings, decisions, and actions taken during claim processing. o Maintain detailed records of each claim reviewed, including correspondence and additional information obtained. o Ensure compliance with regulatory requirements and internal policies regarding confidentiality and data protection. 3. Communication and Collaboration: o Communicate with policy holders, healthcare providers, and internal stakeholders regarding claim decisions and requirements. o Provide guidance and assistance to colleagues regarding medical terminology, coding, and procedural guidelines. 4. Quality Assurance: o Conduct quality reviews of processed claims to ensure accuracy and consistency. Required Qualifications: Medical degree (MBBS/BAMS/BHMS/BUMS) from an accredited institution. Active medical license in the relevant jurisdiction. Knowledge of medical coding systems (e.g.,ICD-10, CPT)and healthcare billing practices. Attention to detail and accuracy in processing claims. Preferred Qualifications: Experience in medical claims review or healthcare administration. Familiarity with insurance industry software and claim processing systems. Strong analytical and decision-making skills. Excellent communication and interpersonal skills. Ability to work independently part of a team. Attention to detail and accuracy in processing claims. Job Type: Full-time Pay: ₹31,500.00 - ₹65,512.07 per month Benefits: Health insurance Provident Fund Work Location: In person
Job Designation-: Insurance TPA, Claim Specialist Roles & Responsibilities-: Candidates should have worked in Hospital Insurance desk (Most Important) 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
Job Designation-: Insurance TPA, Claim Specialist Roles & Responsibilities-: Candidates should have worked in Hospital Insurance desk (Most Important) 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
Job Designation-: Insurance TPA, Claim Specialist Roles & Responsibilities-: Candidates should have worked in Hospital Insurance desk (Most Important) 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 - ₹27,862.52 per month Benefits: Health insurance Provident Fund Experience: total work: 1 year (Preferred) Work Location: In person
Job Designation-: Insurance TPA, Claim Specialist Roles & Responsibilities-: Candidates should have worked in Hospital Insurance desk (Most Important) 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 - ₹27,862.52 per month Benefits: Health insurance Provident Fund Experience: total work: 1 year (Preferred) Work Location: In person
In your role as a Claim Processing Doctor at ClaimBuddy.in, you will be responsible for assessing and evaluating medical claims submitted by policyholders or healthcare providers. Your primary focus will be to ensure that claims are processed accurately and efficiently in adherence to established guidelines and policies. It is essential to have a strong understanding of medical terminology, procedures, and billing practices to make informed decisions based on medical necessity and policy coverage. Key Responsibilities: - Review and Assessment: - Evaluate medical claims to determine validity, accuracy, and completeness of information provided. - Assess medical necessity based on policy guidelines and medical evidence. - Verify the authenticity of medical documentation and reports submitted with claims. - Documentation and Record Keeping: - Document findings, decisions, and actions taken during claim processing. - Maintain detailed records of each claim reviewed, including correspondence and additional information obtained. - Ensure compliance with regulatory requirements and internal policies regarding confidentiality and data protection. - Communication and Collaboration: - Communicate with policyholders, healthcare providers, and internal stakeholders regarding claim decisions and requirements. - Provide guidance and assistance to colleagues on medical terminology, coding, and procedural guidelines. - Quality Assurance: - Conduct quality reviews of processed claims to ensure accuracy and consistency. Qualifications Required: - Medical degree (MBBS/BAMS/BHMS/BUMS) from an accredited institution. - Active medical license in the relevant jurisdiction. - Knowledge of medical coding systems (e.g., ICD-10, CPT) and healthcare billing practices. - Attention to detail and accuracy in processing claims. ClaimBuddy.in is a MediClaim support company dedicated to providing a one-stop solution for claim assistance for Patients and Hospitals. The company is focused on leveraging technology and robust processes to ensure hassle-free insurance claims for all stakeholders involved. Job Type: Full-time Benefits: - Health insurance - Provident Fund Work Location: In person,
At ClaimBuddy Technologies, we count on the customer service department to interact professionally with our valued customers when they have questions or concerns. We’re seeking a highly skilled customer service representative to join our team and handle inbound and outbound phone calls, email requests, and face-to-face interactions with a friendly and helpful approach. The ideal candidate is a quick learner who can think on their feet and resolve any issues with a customer-first business mentality. This person should also have experience in sales, as opportunities may arise to promote the company's products and services. The most successful customer service representative will have the communication and interpersonal skills needed to provide support, answer questions, and resolve issues in an efficient manner. Serving as the voice and face of our company, the representative will be integral in reinforcing our reputation for exceptional customer service. Required skills and qualifications Graduate and post graduate Strong communication skills, including active listening and clear articulation Ability to solve problems, alleviate conflicts, and escalate tactfully Ability to multitask, manage time, and prioritize Ability to work individually and as a team member Job Type: Permanent Pay: ₹24,043.57 - ₹34,608.66 per month Benefits: Health insurance Language: English (Required) Hindi (Required) Work Location: In person
At ClaimBuddy Technologies, we count on the customer service department to interact professionally with our valued customers when they have questions or concerns. We’re seeking a highly skilled customer service representative to join our team and handle inbound and outbound phone calls, email requests, and face-to-face interactions with a friendly and helpful approach. The ideal candidate is a quick learner who can think on their feet and resolve any issues with a customer-first business mentality. This person should also have experience in sales, as opportunities may arise to promote the company's products and services. The most successful customer service representative will have the communication and interpersonal skills needed to provide support, answer questions, and resolve issues in an efficient manner. Serving as the voice and face of our company, the representative will be integral in reinforcing our reputation for exceptional customer service. Required skills and qualifications Graduate and post graduate Strong communication skills, including active listening and clear articulation Ability to solve problems, alleviate conflicts, and escalate tactfully Ability to multitask, manage time, and prioritize Ability to work individually and as a team member Job Type: Permanent Pay: ₹24,043.57 - ₹34,608.66 per month Benefits: Health insurance Language: English (Required) Hindi (Required) Work Location: In person
Key responsibilities Collection: Request, gather, and collect necessary documents from external parties like clients, customers, or candidates. Verification: Review submitted documents for accuracy, completeness, and compliance with internal policies and legal requirements. Coordination: Act as a point of contact, coordinating between external parties and internal departments to facilitate the process. TRAVELLING: Need to travel by Bike to collect the document from the hospitals. Communication: Provide clear instructions and guidance to individuals providing documents, and address their questions and concerns. Job Types: Full-time, Permanent, Fresher Pay: ₹18,361.28 - ₹22,296.56 per month Benefits: Health insurance Provident Fund Work Location: In person
Job Designation-: Insurance TPA, Claim Specialist Roles & Responsibilities-: Candidates should have worked in Hospital Insurance desk (Most Important) 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 - ₹27,862.52 per month Benefits: Health insurance Provident Fund Experience: total work: 1 year (Preferred) Work Location: In person
Key responsibilities Collection: Request, gather, and collect necessary documents from external parties like clients, customers, or candidates. Verification: Review submitted documents for accuracy, completeness, and compliance with internal policies and legal requirements. Coordination: Act as a point of contact, coordinating between external parties and internal departments to facilitate the process. TRAVELLING: Need to travel by Bike to collect the document from the hospitals. Communication: Provide clear instructions and guidance to individuals providing documents, and address their questions and concerns. Job Types: Full-time, Permanent, Fresher Pay: ₹18,361.28 - ₹22,296.56 per month Benefits: Health insurance Provident Fund Work Location: In person