Medical Insurance Claims Processor

As a member of the medical insurance claims processing team, you will play a crucial role in verifying medical documents, liaising with hospitals, TPAs, and insurers, and ensuring the accurate and timely processing of claims. Your primary focus will be on documentation, coding/compliance, and effective communication. Key Responsibilities: - Review medical bills, treatment notes, and diagnostic reports to assess insurance claims. - Verify policy coverage, exclusions, and pre-authorizations to ensure accuracy. - Collaborate with TPAs, insurance companies, and hospital billing departments for seamless processing. - Ensure all claims are complete with necessary supporting documentation. - Handle queries, follow-ups, denials, and rejections efficiently. - Maintain records, meet SLAs, and adhere to turnaround times. - Provide medical expertise in reviewing treatment plans, coding, and clinical documentation to support claim adjudication. - Assist senior processing officers/managers as required. Qualifications: - MBBS degree holders (fresh graduates, house-surgeons preferred). - Proficiency in medical terminology, anatomy, and common diagnostics. - Strong written and verbal communication skills with keen attention to detail. - Basic computer skills including working with spreadsheets and claim processing software. - Ability to thrive in a fast-paced environment, manage multiple tasks, and meet deadlines. In addition to the responsibilities and qualifications mentioned above, the company offers competitive salary with incentives/performance bonuses, comprehensive training in insurance claims norms, coding, and policy review, regular working hours with occasional extended hours if necessary, and opportunities for career growth into senior processing or supervisory roles. Please note that this is a full-time position suitable for freshers.,