Junior Officer – Senior Officer

Siddhartha Premier Insurance Limited invites applications from qualified, dynamic, and result-oriented citizens for the following positions:

Position: Junior Officer – Senior Officer ( Medi Health unit of claim department)
No. of Vacancy: 1
Location: Head Office, Anamnagar, Kathmandu

Qualifications:

• Candidates should possess minimum Bachelor degree in Pharmacy/Pathology/Nursing or MBBS holder.·
• Candidates with a Bachelor’s degree in science (preferably Biology or related disciplines) with relevant experience in health insurance claims may also apply.·
• Prior experience in hospital, Pharmacy and or related fields are encouraged to apply.

Key Requirements:

• Sound knowledge of medical terminology, diseases, treatment protocols, pharmaceuticals, and healthcare procedures.·
• Understanding health insurance policies, claim adjudication, medical underwriting, and regulatory requirements will be an added advantage.·
• Strong analytical, report-writing, and decision-making skills.·
• Effective communication and people skills with the ability to coordinate with hospitals, insured clients, surveyors, and healthcare providers.·
• Proficiency in Microsoft Office applications and claim management systems.·
• Prominent level of integrity, accuracy, and diligence.

Job Responsibilities:

• Candidate should have effective communication skills and shall manage inquiries related to Pharmacy, especially during claim inspection.·
• Developing and filing new products for Health Insurance.·
• To incorporate empanelment with different hospitals in Kathmandu valley and to tie up with them for business Support.·
• To get quotations from different empaneled hospitals with lowest rate and provide discounted rate of cashless health insurance benefit to the prospective customers than that of Competitors in the market.·
• To function as a mediator and Claim Assessment team between empaneled hospital and Siddhartha Premier Insurance Ltd.·
• Training of Empaneled hospitals Personnel regarding Cashless Health Insurance benefits provided under the policy issued.·
• Ensure that cashless benefit offered to the customers is restricted to coverage offered under the policy and no excess benefit is paid by the hospitals with which MOU is entered.·
• Identifying & generating details of prospective areas for Health Insurance and plan and strategies opted to generate business there from.·
• Cashless benefit payment cycle should be made effective, and claims should be timely paid off.·
• Creation of Underwriting Guidelines.·
• Monthly reviewing of the Claim Procedure made and reporting the same to the higher Authority without fail.·
• Perform any other duties assigned by the Head of the Claims Department or management.

How to Apply:

Apply online at: https://siddharthapremier.rigojobs.com

Detailed job descriptions and requirements are available on the application portal

Only shortlisted candidates will be contacted

Application Deadline: 29 July, 2026

Tagged as: Kathmandu