Executive to Assistant Manager - Health Claims - Cashless – Medical

Description

Purpose of this role: A medical cashless claims processor to be available round the clock (24 X 7 service) for any emergency hospitalization requirements. Cashless medical management, coordination and claim adjudication. This role requires to validate the information on all medical claims from the customer seeking payment from Future Generali. Claims must be thoroughly reviewed to ensure that there is no missing or incomplete information. In addition, a processor must keep meticulous records of claims and follow up on lapsed cases.

Main Responsibility
1. To coordinate with hospitals / customers for pre authorization
2. To register and process cashless preauthorization request received from hospital
3. Error free claim adjudication/processing as per process norms
4. Responsible for coordination with clients& providers to ensure faster turnaround time for claims
5 To facilitate hospital admissions in case of emergencies.
6 Provide regular inputs to enhance service quality
7 Assessing the claim on medical admissibility.

Education : Bachelor of Ayurveda/Homeopathy/Medicine from any recognized institute (BAMS, BHMS &MBBS)

Experience : Experience of minimum 1 or 2 years in any TPA / Insurance Company in a similar function