Clinical Manager

Care.fi is a new age Health fintech startup based out of Gurgaon, offering smart financing and claim management solutions to hospitals.

With a focus on driving efficiencies through technology, Care.fi provides seamless financing and revenue cycle management solution for healthcare providers. The company has strong institutional investor backing and founders with over 20 years of experience in the industry.

What You'll Do

We’re seeking a clinically experienced insurance claim manager to drive the clinical backbone of our revenue cycle operations. As the Clinical Manager, you will help a team of claim processor, ensuring precision in claim validation, reducing denials and enabling accurate documentation. You’ll play a critical role in blending clinical insight with operational excellence and innovation.

Clinical Strategy & Team Leadership

• Lead a team involved in processing reimbursement claims
• Clinically approve or reject claims basis Insurance understanding and specific T&C of policy
• Define clinical protocols, ensure adherence to quality and compliance standards and drive continuous improvement.

Claims & Documentation Oversight

• Act as the clinical authority for complex case reviews and appeals.
• Guide hospital teams to resolve documentation gaps and strengthen case submissions.
• Identify patterns in denials, lead root-cause audits and implement corrective action strategies.

Technology-Driven Innovation

• Collaborate with the tech team to co-build AI-driven clinical validation tools.
• Structure clinical logic and data points that power our LLMs and automation engines.

What We're Looking For

• Minimum 5 years of clinical experience, RCM, hospital administration or claims in Insurance company
• Prior experience leading clinical/medical teams in high-performance environments
• Medical background (MBBS, BAMS, BHMS, BDS, B.Pharma) or a strong insurance background is preferred
• Ability to work cross-functionally with business, product, and tech stakeholders
• Strong communication, leadership and decision-making skills