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