Health Claims Specialist

Role Overview We are looking for a detail-oriented Health Claims Specialist to join our BFSI operations team at 3i Infotech, Mumbai. In this role, you will be responsible for quality checking health insurance claims by cross-verifying system data against physical and digital claim documents. This is an excellent opportunity for professionals with a background in health insurance or TPA operations to grow within a reputed IT services organisation. Key Responsibilities - Match system records with health claim documents such as bills and discharge summaries to identify discrepancies - Review and identify non-payable items from pharmacy bills during the claims adjudication process - Ensure accuracy and completeness of claim documentation including medical records and supporting forms - Carry out quality control checks on health insurance claims in compliance with operational guidelines - Maintain thorough records of processed claims and flag exceptions for review Required Qualifications - Graduate in any discipline from a recognised university - 1 to 2 years of hands-on experience in health insurance or TPA operations - Strong understanding of health claim documents, medical billing, and insurance claim workflows - Familiarity with mediclaim, Medicare, and general insurance claim settlement processes - Proficiency in identifying mismatches and non-payable items with a sharp eye for detail Why Join Us 3i Infotech is a well-established IT services and consulting company offering stable full-time permanent roles with real growth opportunities in the BFSI sector. With 20 open positions, we are actively building a skilled claims operations team and welcome candidates who are ready to make an immediate impact.

- 1 to 2 years of experience in health insurance or TPA operations - Graduate in any discipline - Knowledge of health claim document processing and adjudication - Familiarity with mediclaim, Medicare, and medical billing practices - Experience with claim forms, discharge summaries, and pharmacy bills - Strong attention to detail and ability to spot data mismatches quickly - Understanding of non-payable items in pharmacy and hospital billing