Claim Investigator/Senior Medical Officer

Medi Assist; Bengaluru; Sur place; INR 600 000 - 900 000; Plein temps

Résumé du poste

Medi Assist in Bengaluru is seeking a claims processing professional with 2–3 years of experience in international medical claims. The role involves verifying insured information, analyzing claims, requesting missing details, and processing payments on the system.

The candidate should be able to adjudicate benefits, coordinate with medical/membership teams, and maintain Excel MIS with periodic reporting. Night shifts are required. BAMS/BHMS/BDS are preferred qualifications.

Qualifications

• 2–3 years of experience in processing international or overseas medical claims is a plus.
• Preferably male candidates with BAMS, BHMS or BDS qualifications.
• Willingness to work night shifts (rotational).

Responsabilités

• Verify & validate information submitted by the insured
• Analyze claims based on information shared by insured and admin team
• Request missing information via email or phone
• Assess claims vis-à-vis insured coverage
• Process claims for payment on the processing system
• Coordinate with medical/membership teams as required
• Adjudicate claims as per benefits
• Maintain MIS in Excel; generate periodic reports
• Night shift readiness

Connaissances

Claim processing

Excel

MIS reporting

Communication (email/call)

Formation

BAMS

BHMS

BDS

Outils

Processing system

Description du poste

Key Responsibilities

• Verify & validate the information submitted by the Insured
• Analyze the submitted claim based on the information shared by the insured and details entered by the admin team
• Request for any information missing from the claim file via email or call
• Assess claim submitted vis--vis the coverage of the insured
• Process claims for payment on the processing system
• Co-ordinate with intra department (medical/membership) based on defined scenarios/limits
• Adjudication of claims as per benefits
• Maintain MIS in excel, Periodic reporting.
• Willing to work in Night (rotational) shifts
• 2 to 3 years experience in processing international or overseas medical claims would be an added advantage. (Preferably Male candidates with BAMS, BHMS, BDS Qualification)