Clinical Underwriter Thane (India)

Role Overview:

As an Insurance Claims Underwriter at CareFi, you will play a crucial role in evaluating healthcare insurance claims by utilizing your deep clinical knowledge. Your responsibilities will include assessing medical risks associated with claims, collaborating with healthcare providers and business teams, and ensuring efficient and compliant processing of all claims.

Key Responsibilities:

• Claim Evaluation: Review and analyze medical records, health conditions, and treatment plans to underwrite insurance claims accurately. Verify if the provided treatment is covered by the insurance policy.
• Risk Assessment: Analyze financial and clinical risks related to claims, especially in high-value and complex cases, to make appropriate decisions.
• Team Oversight: Supervise the clinical underwriting team's performance and efficiency, ensuring tasks are completed within set timelines and maintaining high service levels.
• Strategic Input: Collaborate with Business Unit (BU) heads, offering data-driven insights and feedback to enhance product offerings and support recent product development initiatives.
• Bill Validation: Generate approval letters based on treatment and insurance coverage.
• Escalations: Address hospital escalations concerning approval amounts.

Qualification Required:

• Minimum of 3 years of experience in clinical underwriting, healthcare insurance, or a related role within the healthcare or insurance sectors.
• Medical background (MBBS, BAMS, BHMS, BDS, B.Pharma) or a strong insurance background preferred.
• Proficiency in Microsoft Office, Microsoft skills, and tech tools.
• Strong analytical thinker with a proactive problem-solving approach.
• Excellent team collaboration skills and a strong work ethic.
• Effective verbal and written communication abilities.
• Willingness to work from the office six days a week. Role Overview:

As an Insurance Claims Underwriter at CareFi, you will play a crucial role in evaluating healthcare insurance claims by utilizing your deep clinical knowledge. Your responsibilities will include assessing medical risks associated with claims, collaborating with healthcare providers and business teams, and ensuring efficient and compliant processing of all claims.

Key Responsibilities:

• Claim Evaluation: Review and analyze medical records, health conditions, and treatment plans to underwrite insurance claims accurately. Verify if the provided treatment is covered by the insurance policy.
• Risk Assessment: Analyze financial and clinical risks related to claims, especially in high-value and complex cases, to make appropriate decisions.
• Team Oversight: Supervise the clinical underwriting team's performance and efficiency, ensuring tasks are completed within set timelines and maintaining high service levels.
• Strategic Input: Collaborate with Business Unit (BU) heads, offering data-driven insights and feedback to enhance product offerings and support recent product development initiatives.
• Bill Validation: Generate approval letters based on treatment and insurance coverage.
• Escalations: Address hospital escalations concerning approval amounts.

Qualification Required:

• Minimum of 3 years of experience in clinical underwriting, healthcare insurance, or a related role within the healthcare or insurance sectors.
• Medical background (MBBS, BAMS, BHMS, BDS, B.Pharma) or a strong insurance background preferred.
• Proficiency in Microsoft Office, Microsoft skills, and tech tools.
• Strong analytical thinker with a proactive problem-solving approach.
• Excellent team collaboration skills and a strong work ethic.
• Effective verbal and written communication abilities.
• Willingness to work from the office six days a week.