Walk-in || Medical Officer
- Karthika Consulting
- 0 years
- Bengaluru
- 5 days ago
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Job Description
Job Duties & Responsibilities
- Play as an intermediate role Between the Insurance co. and Hospital andWe AssistTeam.
- Adjudicatingcashless and Reimbursement claims with claim documents provided by help desk executive.
- Should be able to do claim tabulation to bifurcate payable and non-payable items as per the terms and conditions laid out in the insurance policy.
- Evaluating claims and posting remarks inwhatsapp group and updating in CRM.
- Monitoring billing as per the Tariff.
- Managingclaimsescalations from hospitals.
- Responsibletohandlingqueriesraised by insurance company / TPAs
- Provide technicalassistanceand conduct training sessions for new processors on various health insurance policies.
- Evaluate complete claim documents before submission.
- Final Approval of Tabulation done by the team
- Coordinate withthe Internalteam to understand patient enquiries.
- Helping team to understand the Non-medical Items.
- Periodically educatingthe claimassistancedepartmentaboutthe changes in the policy, rules ulationsand applicationdeduction on settlement.
- To create awareness about reimbursement claims. (Pre, Post & Hospitalization)and communicating the important updates to the Claims Assistance and Finance Department
- Be available at theoffice for supporting onsite staffon allsix days in a week b/w 9.30am to7.00pm
- Efficiently and effectively handle grievance / issue raised by hospital staff & patients, escalateissueto theteam leader,Manager Insurance Adjudicationand BusinessHeadas necessary.
- Follow-upon the updates to be given to the clients/ onsite team of Claims Assistance Department
Qualifications & Skills
- BAMS / BHMS/ BDS /Bsc/ MSc / Nursing/Dpharm/Bpharm
- 0 -2yearsofrelevantexperience
- Should have good analytical skills
- Excellent interpersonal & communication skills
Experience
0-2years of experience inTPAorIndianInsuranceclaimsor similar fieldor fresher
Job Classification
Industry: InsuranceFunctional Area / Department: Healthcare & Life SciencesRole Category: Healthcare & Life Sciences - OtherRole: Healthcare & Life Sciences - OtherEmployement Type: Walk-insContact Details:
Company: Karthika ConsultingLocation(s): Bengaluru+ View Contact
Keyskills: Health Claims TPA Tabulation Copay Claims Processing Health Insurance
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₹ 1-2 Lacs P.A
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