Job Description
Job Title: Claims Registration Executive
Level: Executive/ Senior Executive (1-3 years’ experience)
Key Responsibilities:
Claim Initiation & Registration: Receive and register claims (Cashless Pre-authorization or Reimbursement) via email, online portals, mobile apps, or phone, ensuring all details are logged in the Claims Management System (CMS).
Document Verification: Verify policyholder eligibility, coverage, and the completeness of documents (e.g., claim form, discharge summary, medical bills, investigation reports).
Data Accuracy: Ensure accurate data entry of patient details, diagnosis codes, and hospital information into the system.
Inter-departmental Coordination: Coordinate with Third Party Administrators (TPAs), hospitals, and internal medical teams for smooth claim handling.
Communication: Handle customer queries regarding claim procedures, status, and outstanding requirements via phone or email.
Confidentiality & Compliance: Ensure compliance with company policies, regulatory guidelines (e.g., IRDAI), and maintain the confidentiality of medical records.
Record Maintenance: Maintain and scan claim documents securely, creating proper logs and reports.
Required Skills & Qualifications:
Education: Bachelor’s degree in any discipline.
Experience: 0-3 years of experience in insurance claims.
Technical Skills: Proficiency in MS Excel and MS Office; familiarity with Claims Management Software is preferred.
Domain Knowledge: Basic understanding of health insurance policies, medical terminology, and TPA procedures.
Job Types: Full-time, Permanent, Contractual / Temporary
Pay: ₹300,000.00 - ₹450,000.00 per year
Benefits:
Flexible schedule
Provident Fund
Work Location: In person
Level: Executive/ Senior Executive (1-3 years’ experience)
Key Responsibilities:
Claim Initiation & Registration: Receive and register claims (Cashless Pre-authorization or Reimbursement) via email, online portals, mobile apps, or phone, ensuring all details are logged in the Claims Management System (CMS).
Document Verification: Verify policyholder eligibility, coverage, and the completeness of documents (e.g., claim form, discharge summary, medical bills, investigation reports).
Data Accuracy: Ensure accurate data entry of patient details, diagnosis codes, and hospital information into the system.
Inter-departmental Coordination: Coordinate with Third Party Administrators (TPAs), hospitals, and internal medical teams for smooth claim handling.
Communication: Handle customer queries regarding claim procedures, status, and outstanding requirements via phone or email.
Confidentiality & Compliance: Ensure compliance with company policies, regulatory guidelines (e.g., IRDAI), and maintain the confidentiality of medical records.
Record Maintenance: Maintain and scan claim documents securely, creating proper logs and reports.
Required Skills & Qualifications:
Education: Bachelor’s degree in any discipline.
Experience: 0-3 years of experience in insurance claims.
Technical Skills: Proficiency in MS Excel and MS Office; familiarity with Claims Management Software is preferred.
Domain Knowledge: Basic understanding of health insurance policies, medical terminology, and TPA procedures.
Job Types: Full-time, Permanent, Contractual / Temporary
Pay: ₹300,000.00 - ₹450,000.00 per year
Benefits:
Flexible schedule
Provident Fund
Work Location: In person
💡 Quick Summary
Seeking a career-building opportunity? The Claims Officer position is now open for candidates interested in the Insurance sector. This role in Mumbai offers a professional environment and growth potential.
Requirement Snapshot: Candidates should possess basic communication skills, a proactive attitude, and the ability to work in a team. Experience in Insurance is a plus.
