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JOB RESPONSIBILITIES Applying medical knowledge in evaluating the medical claim files to ascertain the medical admissibility. Must understand the policy wordings including Terms & conditions to adjudicate the Admissibility/Rejection. Processing of claims as per regulatory guidelines. Adhering to the TATs in processing. Quality review of processed files. Grievance redressal, handling escalations and identifying the fraudulent claims. CANDIDATE PROFILE: Qualification must be BAMS, BHMS or BDS Only BAMS & BHMS freshers will be considered BDS candidates must have prior health claims processing experience Candidate must be comfortable with work shifts on roster basis & rotational week-off. .