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Assistant Manager - Health Claims

Even is a healthtech company, taking on the audacious task of solving healthcare in India. We’re a monthly subscription based healthcare provider that partners with the top hospitals in India to offer unlimited OPD (diagnostics and doctor consultations) and hospitalisation up to INR 50 lakh a year. We pay our members’ hospital bills so they can spend their money on the things they love. #FeelFree

As a Senior Manager - Health Claims, you will drive cashless/reimbursement services, adjudication and fraud management of claims.

What you will do

  • Set up and continuously improve the cashless/reimbursement process along with it’s required governance and fraud management
  • Ensure claims are adjudicated as per organization guidelines laid down under SOP and adhering the policy T&C
  • Innovate and strengthen existing claims process to ensure best in class customer service
  • Research, review, summarize and recommend course of action on claims where an appeal or a grievance has been filed for a denied /underpayment
  • Ensure adherence and fulfilment of critical claims metrics such as TATs, data driven decision making, quality control for B2C and B2B claims, etc

What you will need

  • Medical degree with at 5-10 years of work experience in insurance/TPA industry with good knowledge of health claims adjudication and stakeholder management
  • Comprehend, analyse and apply vast amounts of medical information to make a sound claims decision
  • Sound working knowledge of insurance principles, claims guidelines, and product features for effective risk analysis with an eye for details

Compensation & Benefits

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Compensation
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Benefits, Days off, Expenses & Reimbursements

Where to apply

Drop us an email to jobs@even.in and our talent team will reach out to you.