Senior manager-clinical support |MBBS/BHMS |Health Insurance | Indore

Role & responsibilities

- Handle customer calls related to health insurance claims and medical queries.

- Review the customer's disease/medical condition, diagnosis, and treatment details related to the claim.

- Verify medical prescriptions, medicines, investigation reports, and other relevant medical documents.

- In case of hospitalization, verify the hospitalization details and claim information.

- Check whether the hospital and treatment are covered/eligible as per the customer's insurance policy.

- Verify medical and claim details against policy terms and coverage requirements.

- Provide customers with appropriate medical guidance and clarification regarding treatment and claim-related queries.

- Coordinate with customers and relevant internal teams during the claim verification process.

- Handle customer interactions over the phone with clear and professional communication.

- Maintain accurate documentation and ensure timely completion of claim verification and customer support activities.

- The role involves both customer advisory and medical/claim verification responsibilities.

Preferred candidate profile

• MBBS / BHMS qualified candidates only
• Candidates with Corporate Doctor / Clinical Support experience preferred
• Experience in Health Insurance, Medical Claims, Claims Verification or Healthcare Operations will be an advantage
• Strong verbal and written communication skills
• Good understanding of medical documents, prescriptions, diagnosis and treatment
• Comfortable handling customer calls and providing medical guidance
• Candidates willing to relocate to Indore can apply
• Comfortable working in rotational day shifts
• Candidates available to join in October 2026 preferred.

Contact HR MUSKAN [phone removed]