About Job

Claim handler working on OPD (Outpatient Department) claims,

Skills & Qualification

• Medical background

• Healthcare expertise

•  Strong analytical and attention-to-detail skills

  Ability to identify policy compliance issues or mismatched documentation

  Clear and professional email communication with customers and internal teams

  Ownership of cases until closure (especially when follow-up documents are pending)

Responsibilities

• ·       Understanding of OPD coverage under different policy types (corporate, retail, etc.).

  ·       Ability to interpret policy terms, sub-limits, and exclusions related to OPD.

  ·       Familiarity with standard treatment and diagnostic codes (ICD, CPT, or similar).

  ·       Knowledge of claim processing workflows — from registration to adjudication and payment.

  ·       Awareness of fraud indicators (e.g., repeated consultations, manipulated invoices, or fabricated prescriptions).

• Proficiency in the claim processing system