Case Management Coordinator

Role Overview Vidal Health Insurance is looking for a skilled Case Management Coordinator with a strong medical background and hands-on experience in the insurance or TPA sector. This is a full-time, permanent opportunity based in Bengaluru for a qualified medical professional who can bridge clinical knowledge with insurance operations. You will play a key role in evaluating medical cases, managing claims, and collaborating with hospitals to deliver efficient and compliant case resolutions. Key Responsibilities - Review medical records, hospitalization cases, and treatment plans to assess clinical appropriateness and policy compliance - Negotiate treatment costs and billing charges directly with hospitals and healthcare service providers - Coordinate with internal teams and external hospital stakeholders to drive smooth case management and timely claim resolution - Provide expert clinical opinions on the necessity of treatment, recommended length of stay, and opportunities for cost optimisation - Ensure all case handling adheres to established clinical protocols, billing standards, and insurance policy guidelines - Prepare, maintain, and analyse case management and billing reports for reporting and decision-making purposes Required Qualifications - MBBS, BDS, BHMS, BAMS, or BUMS degree with a valid medical registration - 2 to 5 years of experience in insurance, TPA operations, hospital administration, or claims management - Solid understanding of health insurance processes, TPA workflows, and medical billing practices - Strong clinical assessment, analytical, and problem-solving capabilities - Excellent negotiation, communication, and decision-making skills - Ability to handle multiple cases simultaneously in a fast-paced work environment Why Join Us Vidal Health Insurance is a respected name in the health insurance and TPA space, offering a professional environment where your clinical expertise truly makes an impact. This role offers a competitive salary, growth opportunities, and the chance to contribute meaningfully to patient care outcomes through smart case management.

- MBBS, BDS, BHMS, BAMS, or BUMS with valid registration - 2 to 5 years in insurance, TPA, or claims management - Knowledge of health insurance and medical billing - Clinical assessment and analytical skills - Negotiation and communication abilities - Ability to manage multiple cases efficiently

- Competitive salary in the range of 3.25 to 5 LPA - Full-time permanent employment - Professional growth in the insurance and healthcare sector