Medical Risk Assessment & Underwriting Specialist Role Overview: This position is responsible for evaluating health insurance proposals and medical claims, assessing risk, and ensuring decisions are made in accordance with policy guidelines and regulatory compliance. The candidate should combine sound clinical judgment with strong underwriting acumen and innovative approaches to case evaluation. Key Responsibilities Review and process medical documentation and insurance claims to ensure accuracy, completeness, and compliance. Analyze patient information, laboratory findings, and treatment histories for risk assessment and decision-making. Determine coverage eligibility, exclusions, and appropriate premium modifications based on health risk profiles. Collaborate with healthcare providers, policyholders, and team members to resolve discrepancies and communicate outcomes. Guide acceptance or rejection of health proposals, applying robust risk evaluation techniques and recommending appropriate risk loading when necessary. Extract insights from Claims MIS and use data analytics to enhance underwriting decisions. Monitor regulatory changes and industry trends to continuously improve risk evaluation processes. Contribute innovative ideas for process optimization and risk mitigation. Required Skills & Competencies Strong foundation in medical science and clinical documentation. Expertise in health risk underwriting and claims assessment. Analytical mindset, detail orientation, and critical thinking skills. Ability to communicate clearly and collaborate with diverse stakeholders. Experience extracting and interpreting insights from claims data systems. Creative problem-solver, open to process innovation and improvement. Qualifications Bachelors or Master’s degree in life sciences, healthcare, insurance, or related field. Prior experience in health underwriting, medical risk assessment, or claims processing. Familiarity with healthcare regulations and compliance standards. This role requires individuals who can combine deep clinical insights and insurance expertise with creative, data-driven problem-solving to deliver fair, innovative risk assessments for health insurance proposals.
Designation: Medical Representative Role Objective: To on-board doctors in targeted categories (General Physicians, Dialectologists, Cardiologists, Paediatricians, Gynaecologists, Dermatologists) and drive prescription-linked business. Roles & Responsibilities: Identify and approach doctors in assigned beats. Pitch partnership benefits (patient engagement, pharma tie-ups). Negotiate and close on boarding agreements. Coordinate with supply chain for smooth medicine delivery. Maintain CRM records and daily activity reports. Achieve monthly on boarding and revenue targets. Required Skills • Strong communication and persuasion skills. Knowledge of pharma products and compliance. Ability to work in field and meet target Basic tech skills (CRM, mobile apps) Qualifications: Graduate in Science/Pharmacy preferred. 13 years experience in pharma sales or doctor engagement. Local beat knowledge is a plus. Location: Navi Mumbai / Western Lines KPIs: Number of doctors on boarded per month. Monthly revenue from on boarded doctors. Beat coverage efficiency
Livlong 365 is a leading Health-Tech company dedicated to building a seamless and comprehensive healthcare ecosystem. From Insurance to OPD Wellness to a robust Marketplace for top-rated Doctors and Specialists, we offer a full spectrum of healthcare solutions. Our services include doctor consultations, lab tests, health plans, OPD packages, home care, elderly care, medicines and more. In Parallel, we are into distribution of health & general insurance products across retail as well as corporate segments, with a strong presence across various channels such as: Bancassurance, Agency, Corporate & VRM, Partnerships and Digital. Deploying cutting-edge technology, Livlong 365 continues to lead the health-tech sector by transforming data-driven insights into tailored solutions that meet the evolving needs of modern healthcare. Rooted in transparency and backed by a vast, reliable infrastructure, we prioritize care and compassion in every interaction. With a nationwide reach, we ensure quality healthcare is always within easy access for all. https://www.livlong.com/ Job Descripon (Dot Net) Designaon Department Backend Developer Technology Write clean, maintainable, and ecient code using .NET technologies such as C# and .Net Core. Roles and Responsibili¢es ¢ Work with rela¢onal databases like SQL Server or NoSql, wri¢ng SQL queries, stored procedures, and managing database interac¢ons. ¢ Build and maintain RESTful APIs to facilitate communica¢on between dierent components of the applica¢on or with external systems. ¢ Write and execute unit tests to ensure code quality and maintainability, using tes¢ng frameworks like NUnit or xUnit. ¢ U¢lize version control systems like Git for managing codebase, branching, and merging changes. ¢ Work closely with cross-func¢onal teams including designers, testers, and project managers to deliver highquality so¢ware solu¢ons within project ¢melines. • Web API Exp in developing Web API Skill Set (Technical and So¢ Skills) OOPS • • • • • • SQL C#, .Net Core Design pattern Entity Framework Optional: Microservices Architecture, Chai / Mocha / unit test framework / Test driven development. Good to Have: MVC Process Exposure ¢ Able to interact with team and understand func¢onal requirements and create design documents for new features. ¢ Exposure to bug xing, maintenance, con¢nuous integra¢on releases. ¢ Par¢cipate in sprint planning and story elabora¢on sessions. ¢ Candidate should be able to work independently in an Agile project. ¢ Experience with Test-Driven Development, Integra¢on tes¢ng and Agile processes. ¢ Reviews peer's code from a standard and design adherence perspec¢ve Thane Job Loca¢on
Role & responsibilities • Critically evaluate information gathered from multiple sources, reconcile conflicts and decompose high-level information into details. • Should be able to understand Indian Insurance business requirement, regulatory constraints (IRDA) and explain the same to technical team • Create and maintain workflows, approval processes, and validation rules based on internal stakeholder requirements. • Ensure issues are identified, tracked, reported on and resolved in a timely manner. • Work with business unit personnel to identify required changes and communicate Create Process Flows, which can later be converted into BRDs for development • Ability to push creative thinking beyond the boundaries of existing industry practices is required. • Ability to plan and monitor according to the needs of the project and the team. Preferred candidate profile • Good written and oral communication • Positive attitude and strong inclination towards learning • Good requirement gathering and elicitation skills. • Motivated to work in Insurance and Wellness domain • Should have good knowledge of Insurance Products, especially Health Insurance • Prior experience in Insurance Domain is mandatory. Should have worked with either an insurance company (preferably health insurance) or insurance broker • Prior tech experience is good to have, but is not mandatory Expected Educational Qualification • Must possess strong leadership skills and generate enthusiasm among team members