Claims Executive

Naukri E-hire; Mumbai; On-site; INR 1,200,000 - 1,800,000; Full time

Job summary

Naukri E-hire in Mumbai seeks an experienced claims professional to manage health claims end-to-end, ensuring accurate, timely processing and settlement.

You will analyze medical records, policies and regulations to determine claim validity, and collaborate with TPA partners to resolve complex issues while upholding regulatory compliance and customer satisfaction.

Experience in mediclaim is preferred.

Qualifications

• 4–11 years of experience in health insurance claims handling or processing.
• Strong knowledge of health claims, mediclaim, and related regulations.
• Ability to multitask with high attention to detail.

Responsibilities

• Manage health claims from receipt to settlement with timely processing.
• Analyze medical records, policies, and regulations to assess claim validity.
• Coordinate with TPA partners to resolve complex claims issues.
• Ensure regulatory compliance and high customer satisfaction.

Skills

Health claims knowledge

Multitasking

Job description

Roles and Responsibilities :

• Manage health claims from receipt to settlement, ensuring timely and accurate processing.
• Conduct thorough analysis of medical records, policies, and regulations to determine claim validity.
• Collaborate with TPA (Third Party Administrator) partners to resolve complex claims issues.
• Ensure compliance with regulatory requirements and maintain high levels of customer satisfaction.

Job Requirements :

• 4-11 years of experience in claims handling, adjudication, or processing in the health insurance industry.
• Strong knowledge of health claims, mediclaim, medical insurance, and related laws/regulations.
• Proficiency in managing multiple tasks simultaneously while maintaining attention to detail.