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
Where to apply
Drop us an email to email@example.com and our talent team will reach out to you.