2 - 3 years
2 - 3 Lacs
Posted:1 week ago|
Platform:
On-site
Full Time
Vidal is hiring for Claims-Executive/Team leader Level
Work Location: Jaipur
Work from Office only
Key Responsibilities
Claim Review & Validation
- Examine submitted claims for completeness and accuracy
- Verify policy coverage and eligibility- Identify discrepancies or missing documentation
Claims Processing
- Enter and adjudicate claims in the system (cashless & reimbursement)
- Calculate payable amounts as per policy terms- Ensure timely processing within defined SLAs
Stakeholder Communication
- Liaise with policyholders, hospitals, and insurers for claim clarifications
- Respond to queries and provide claim status updates- Coordinate with Preauth and Customer Care teams
Documentation & Compliance
- Maintain detailed records of claims and actions taken
- Ensure adherence to IRDAI guidelines and internal SOPs- Flag potential fraud or irregularities for investigation
Reporting & Analysis
- Generate daily/weekly/monthly claim reports
- Track claim trends and highlight recurring issues- Support audits and internal reviews with accurate data
Skills & Competencies
Experience Required
Interested candidate can connect 9971006988
Job Types: Full-time, Permanent
Pay: ₹22,000.00 - ₹25,000.00 per month
Experience:
Work Location: In person
Vidal Health Insurance TPA Private Limited
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