01Overview
Department: Health Insurance : Claims operations
Designation : Executive / Senior Executive
Location : Jaipur ( Corporate Office )
Mail ID - khushi@shriramgi.in
Nature- On Roll
Salary Range As per Industry Norms.
Qualification: B.Sc Nursing / B. Pharma
Experience - 1years + in relevant field / Freshers can also apply
Job Description
We are seeking a detail-oriented Health Operations Claims Associate/Executive to support health insurance claims operations.
The role involves reviewing claim submissions, assessing medical documentation, coordinating with healthcare providers, processing claim settlements, and ensuring compliance with claims guidelines and regulatory requirements.
Key Responsibilities
Review health insurance claim forms and supporting medical documents.
Coordinate with hospitals, TPAs, and customers for additional document collection or clarification.
Support claim processing, adjudication, and settlement activities.
Follow up with customers and branches for pending requirements.
Maintain claims records, MIS reports, and operational dashboards.
Ensure compliance with company policies and regulatory requirements.
Meet turnaround time (TAT) and service-level agreement (SLA) targets.
Required Skills
Knowledge of health insurance and claims processes.
Analytical and risk assessment skills.
Good communication and coordination skills.
Proficiency in MS Excel and operational systems. .
