Senior Manager – Health Management Team

We have exciting opportunities for the role of Senior Manager – Health Management Team
Location: Mumbai
Interested candidate can share resume sayyeda.nurani@icicilombard.com with Senior Manager – Health Management Team subject line and share below details.
Current Salary
Expectation
Notice Period
Education (Full Time / part Time
Key Responsibilities:
Claims Assessment: Evaluate and process health insurance claims in accordance with policy terms and conditions.
Medical Review: Identify and flag potential cases of medical abuse or discrepancies in treatment protocols.
Admissibility Decision: Determine claim eligibility based on thorough review of medical documentation and policy guidelines.
Tariff Adjudication: Review and authorize cashless approvals, ensuring alignment with applicable tariffs and negotiated rates.
Stakeholder Coordination: Liaise effectively with internal teams, network hospitals, and other external stakeholders to ensure smooth claim processing and resolution.
Qualifications & Skills:
MBBS/BAMS/BHMS or equivalent medical qualification (preferred).
Strong understanding of health insurance policies and medical terminology.
Analytical mind-set with attention to detail.
Excellent communication and decision-making skills.
Ability to work collaboratively in a fast-paced environment.
Flexible to work in rotational shifts
Experience Required: 1-2 years in Health Insurance Claims/Underwriting/Investigation etc.
Regards,
Saba Naik

Work arrangement
No