Job Designation-: Insurance TPA, Claim Specialist
Roles & Responsibilities-:
Candidates should have worked in the Hospital Insurance desk (Most Important)
Provide Medical opinion for Health Insurance Claims
Processing of Cashless Requests & Health Insurance Claim Documents
Proficient with medical terms & systems.
Understanding of Policy terms & conditions & Various Protocols / Guidelines
Understanding of Claims Adjudication / Claims Processing
Maintaining & Ensuring Standard Operating Procedures & Protocols
Ailment-Wise ICD & Procedure Coding
Manage volumes effectively & efficiently to maintain the Turnaround time of processing cases
VIP Claims Processing and TAT Maintenance
Claim Case Management / Cost Management
Requirements-:
At least 2-3 yrs experience in Medical Officer Claims Processing Cashless/Reimbursement cases in any hospital
Good Excellent oral and written communication, negotiation and decision-making skills.
Good customer service/relationship skills and ability to work effectively in a fast-paced environment with shifting priorities.
Immediate Joiner