Claims lead-A&H

Role

• Closed file review and audit.
• Handling closed and open file reviews for third-party administrators and in-house claims.
• Recoveries from third-party administrators for claims processed with errors.
• Highlight areas of improvement.
• Prepare and publish monthly reports.

Candidate Must Have

• In-depth knowledge of medical cases with exposure to ailment treatments, policy coverages for OPD, hospitalization, personal accident, and travel claims.
• Good interpersonal skills.
• Must be proactive and an effective learner.
• Previous experience in audit.
• Good analytical, communication, and negotiation skills.
• Familiarity with basic Microsoft Excel and regulatory changes.
• Minimum 7 years of experience in general insurance Accident & Health claims.

Qualifications

• Degree in medicine (BHMS/BAMS/MBBS).