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· Evaluate medical claims including both out-patient claims and In-Hospitalization Claims under the policy terms and conditions and recommend claims for approval
· Handle claims from receipt of notification to settlement and take into consideration opinions of the outside Doctor's regarding the claims
· Correspond with clients and agents/Investigator regarding claim queries
· Coordinate with Accounts Department regarding claims payments
· Telephonic/Outdoor investigation of facts involved in claims.
· Monitor team reports, direct necessary action, and inform head of department regarding pertinent information
· Prepare the Service Quality complaint log, handle Service Quality projects and maintain claims TAT
· Participate in assigned claims projects as and when required
Qualifications/ Experience/ Capabilities
· Minimum level of Education for this job: Bachelors (medical related field preferred)
· Minimum Experience required for this job: 2 years (preferably in the corporate or billing section of a hospital or in claims in an insurance firm)
Contractual position which can lead to permanent status.
Job Type: Full-time
Pay: From Rs123,456.00 per month
Ability to commute/relocate:
Work Location: In person
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