हेल्थकेयर असिस्टेंट

Key Responsibilities

1. Provider Empanelment & Contracting

            •          Identify, approach, and empanel new hospitals, clinics, diagnostic centres, and specialty providers in line with business requirements.

            •          Negotiate tariffs, package rates, and cashless agreements as per company policy.

            •          Ensure timely renewal of contracts and rate revisions.

2. Network Expansion & Gap Analysis

            •          Conduct periodic gap analysis to ensure adequate geographic and specialty coverage for insured members.

            •          Onboard strategic providers in underserved locations to improve network adequacy.

3. Provider Relations & Servicing

            •          Act as the point of contact for provider queries related to cashless claims, pre-authorisations, reimbursement, and operational escalations.

            •          Conduct provider training and orientation sessions on processes, documentation, and claims protocols.

            •          Resolve provider grievances promptly and maintain strong long-term partnerships.

4. Compliance & Quality

            •          Ensure all provider contracts and processes adhere to IRDAI regulations and internal audit standards.

            •          Verify hospital infrastructure and quality standards before empanelment.

            •          Monitor provider performance (claims turnaround, denial rates, fraud checks).

5. Data & Reporting

            •          Maintain updated provider data in network management systems.

            •          Generate MIS reports on network adequacy, empanelment status, utilisation trends, and provider performance.

            •          Support management in audits, reviews, and regulatory submissions.

• इस फुल टाइम टेलीसेल्स / टेलीमार्केटिंग Job में 0 - 1 वर्षो का अनुभव वाले उम्मीदवारों की जरुरत है।