Work from Office
Full Time
- Evaluate and process insurance claims to determine validity and payment eligibility.
- Review documentation including claim forms, bills, and related records for accuracy and
completeness.
- Interpret policy terms to determine coverage and liability.
- Detect and investigate potential fraudulent or suspicious claims.
- Coordinate with internal teams and external stakeholders to resolve claim-related disputes.
- Maintain proper documentation and ensure compliance with regulatory guidelines.
- Support continuous process improvements to enhance claims operations efficiency.
- Bachelor's degree in Insurance, Healthcare Management, B.Pharma/ M.Pharma/ Pharm.D, or B.Sc
Nursing.
- Prior experience in insurance claims processing or a related domain preferred.
- Strong analytical and problem-solving abilities.
- Excellent verbal and written communication skills.
- Proficiency in Microsoft Office and claims management systems.
- High attention to detail with the ability to handle confidential information responsibly.
- Familiarity with insurance products, policies, and regulatory guidelines.
- Experience with claims investigation and documentation review.
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