Non-Clinical Job at Policybazaar in Mumbai
Looking for a Medical Officer job in Mumbai in the insurance sector? Policybazaar for Business is hiring a Medical Officer (Doctor) for TPA and risk analysis roles. This Non-Clinical Job in Mumbai involves evaluating medical claims and performing risk assessments. Candidates will work closely with insurance teams and healthcare providers. It is ideal for doctors interested in non-clinical careers in insurance and risk management. Apply now to join India’s leading insurance marketplace.
About the Company:
Policybazaar, the flagship platform of PB Fintech Ltd., is India’s largest online insurance marketplace, established in 2008. It has transformed the insurance industry by offering transparency, awareness, and a wide range of choices.
Policybazaar for Business, launched in 2021, provides specialized insurance solutions for enterprises. With over 15 business insurance products and services to 25,000+ corporates, it caters to industries such as IT, infrastructure, logistics, hospitality, and renewable energy.
The platform focuses on simplifying insurance, delivering risk analysis, and offering tailored solutions to businesses across India.
Job Details:
- Job Role: Medical Officer (Doctor) – TPA for Insurance and Risk Analysis
- Location: Mumbai, Maharashtra, India
- Job Type: Full-time
- Experience Required: Minimum 5 years
- Industry: Insurance / Healthcare
Key Responsibilities:
Claims Review and Evaluation:
- Review medical claims for accuracy and compliance with insurance policies
- Analyze medical documents from hospitals and clinics
- Assess the medical necessity of treatments and procedures
- Provide second opinions on complex or disputed cases
Risk Assessment and Management:
- Perform risk assessments using medical data and trends
- Identify high-risk or fraudulent cases
- Collaborate with underwriting teams for risk evaluation
Medical Advisory Services:
- Provide medical guidance to TPA teams and insurers
- Act as a liaison between healthcare providers and insurance teams
Policy Development and Compliance:
- Assist in developing medically sound insurance policies
- Ensure compliance with healthcare laws and regulations
- Stay updated with the latest medical advancements
Medical Audits and Reports:
- Conduct audits to verify claims and prevent fraud
- Prepare detailed reports for management and insurers
Collaboration with Medical Providers:
- Communicate with hospitals and clinics for accurate documentation
- Coordinate with medical professionals in complex cases
Educational Requirements for this Job:
- Degree: MBBS, MD, or equivalent medical degree from a recognized institution
- Relevant specialization (preferred but not mandatory)
- Minimum 5 years of experience in the healthcare or insurance sector
- Experience in claims evaluation, insurance, or risk management (preferred)
- Knowledge of healthcare laws and insurance regulations
Skills Required:
- Strong understanding of medical terminology and clinical procedures
- Ability to interpret medical records and assess claims
- Analytical and decision-making skills for risk evaluation
- Excellent communication skills for cross-functional interaction
- Attention to detail and accuracy
- Ability to handle confidential information responsibly
Benefits of this Non-Clinical Job:
- Opportunity to transition into a non-clinical medical career
- Work with India’s leading insurance platform
- Exposure to insurance, risk analysis, and healthcare management
- Collaborative work environment with industry experts
- Career growth in the insurance and healthcare domain
