Mediclaim Analyst

Job Description

We are seeking a candidate responsible for conducting in-depth reviews and evaluations of health insurance (Mediclaim) policies offered by insurers to join our team. The role involves comparing benefits, exclusions, terms, premiums, and regulatory compliance aspects across various plans. The analyst provides insights and recommendations to internal teams, clients, or end-users, not selling policies. Science background and interest in biology will enable to understand medical terminology, allowing for accurate interpretation of policy terms and medical documents. Key Responsibilities: Policy Analysis: Review and interpret the terms and conditions of various health insurance policies. Medical Assessment: Evaluate medical records, diagnoses, treatment plans, and hospitalization details using your understanding of biology and medical science. Internal Coordination: Work with internal teams, to provide clear insights and recommendations on policy-related queries. Reporting & Recommendations: Prepare concise and well-documented reports based on the analysis, highlighting relevant medical and policy-related observations. Continuous Learning: Stay updated with changes in insurance regulations, medical advancements, and internal policies to support accurate analysis. Qualifications and Requirements: Educational Background: Graduation in Biology or any science-related field. Analytical Skills: Strong analytical and logical reasoning skills to interpret both policy documents and medical records. Attention to Detail: High accuracy in document verification and interpretation of information. Communication Skills: Clear and professional communication (written and verbal) for coordination and documentation. Technical Proficiency: Basic working knowledge of Excel, PDF, google sheets and document management systems. Ethical Standards: Strong integrity and commitment to confidentiality. Team Orientation: Ability to collaborate with internal departments. Show more Show less