8 Policy Coverage Jobs

Responsibilities This job is provided by apna.co Key Responsibilities: Medical Review & Claims Adjudication: Assess and validate medical claims based on clinical documentation and policy coverage. Interpret diagnostic reports, treatment plans, and prescriptions to determine claim eligibility. Coordinate with internal medical teams to ensure accuracy in claims decision-making. Customer Interaction & Support: Communicate with policyholders, hospitals, and third-party administrators (TPAs) to explain claim decisions in a clear and professional manner. Handle escalated or complex customer service issues involving medical claims. Offer support and guidance on claim submission processes and docume...

Key Responsibilities Medical Review Claims Adjudication: Assess and validate medical claims based on clinical documentation and policy coverage. Interpret diagnostic reports, treatment plans, and prescriptions to determine claim eligibility. Coordinate with internal medical teams to ensure accuracy in claims decision-making. Customer Interaction Support: Communicate with policyholders, hospitals, and third-party administrators (TPAs) to explain claim decisions in a clear and professional manner. Handle escalated or complex customer service issues involving medical claims. Offer support and guidance on claim submission processes and documentation requirements. Compliance Documentation: Ensure...

Job Description : Risk Assessment and UW Implementation and monitoring of various underwriting guidelines related to Commercial products. Main accountability includes Risk analysis, Risk acceptance, Risk selection, Policy coverage (Policy wording, Add-on covers, Exclusions / Inclusions etc.), Renewal business, etc. within the purview of set Underwriting Guideline to achieve the desired business outcomes Maintain TAT and compliance as per UW authority matrix. Reviewing proposals and providing Inputs in terms of local market dynamics, nature of business, quality of risk and recommendations thereof. Strong market intelligence i.e. a broader view of the market we operate in /competitors details ...

Risk Assessment and UW Implementation and monitoring of various underwriting guidelines related to Commercial products. Main accountability includes Risk analysis, Risk acceptance, Risk selection, Policy coverage (Policy wording, Add-on covers, Exclusions / Inclusions etc.), Renewal business, etc. within the purview of set Underwriting Guideline to achieve the desired business outcomes Maintain TAT and compliance as per UW authority matrix. Reviewing proposals and providing Inputs in terms of local market dynamics, nature of business, quality of risk and recommendations thereof. Strong market intelligence i.e. a broader view of the market we operate in /competitors details for formulating in...

Role Overview: You will be working as a CRM Helpdesk - Claim Processing Executive with a background in health insurance at Watch Your Health. Your main responsibilities will include resolving customer queries related to policy coverage and health claim processes, driving claims application for submission and tracking by employees, acting as the direct point of contact for specific corporate clients, collecting and dispatching claim documents, coordinating with internal claims units to ensure seamless processing, staying updated on health insurance regulations, maintaining data confidentiality, and traveling twice a week between branches to solve customer queries. Key Responsibilities: - Impl...

Risk Assessment and UW Implementation and monitoring of various underwriting guidelines related to Commercial products. Main accountability includes Risk analysis, Risk acceptance, Risk selection, Policy coverage (Policy wording, Add-on covers, Exclusions / Inclusions etc.), Renewal business, etc. within the purview of set Underwriting Guideline to achieve the desired business outcomes Maintain TAT and compliance as per UW authority matrix. Reviewing proposals and providing Inputs in terms of local market dynamics, nature of business, quality of risk and recommendations thereof. Strong market intelligence i.e. a broader view of the market we operate in /competitors details for formulating in...

Role Overview: You will be a part of a Mumbai-based health-tech company specializing in cutting-edge digital health solutions. Your primary role as a CRM Helpdesk - Claim Processing will involve managing claims and providing customer support at a client location. Your responsibilities will include deploying CRM implants, handling customer queries, guiding users in claim processes, acting as a single point of contact for corporate clients, and ensuring smooth claim facilitation. Key Responsibilities: - Deploy CRM implants at client site for claim support - Handle customer queries related to policy coverage and claim processing - Guide users in submitting and tracking claims via the claims app...

Job Description : Risk Assessment and UW Implementation and monitoring of various underwriting guidelines related to Commercial products. Main accountability includes Risk analysis, Risk acceptance, Risk selection, Policy coverage (Policy wording, Add-on covers, Exclusions / Inclusions etc.), Renewal business, etc. within the purview of set Underwriting Guideline to achieve the desired business outcomes Maintain TAT and compliance as per UW authority matrix. Reviewing proposals and providing Inputs in terms of local market dynamics, nature of business, quality of risk and recommendations thereof. Strong market intelligence i.e. a broader view of the market we operate in /competitors details ...