Examine and assess patients and provide appropriate clinical care.
Monitor admitted patients and coordinate with consultants.
Attend emergency and routine medical cases as required.
Maintain accurate medical records and treatment documentation.
Prepare medical reports, summaries and documents required for insurance/TPA processing.
Handle cashless admission and discharge procedures.
Verify insurance/TPA eligibility and patient documents.
Prepare and submit pre-authorization requests to TPAs/insurance companies.
Follow up for approvals, queries and enhancements.
Coordinate with doctors for treatment details and medical justification required by TPAs.
Coordinate with Billing, Medical Records, Nursing and Discharge departments.
Ensure timely submission of claim-related documents.
Handle patient/attendant queries regarding insurance and cashless procedures.
Maintain records of TPA cases, approvals, pending queries and claim status.
Ensure compliance with hospital protocols and insurance/TPA requirements.