Job Description

• Achieving required processing targets assigned by the team leader or supervisor on daily, weekly and monthly basis.
• Ensure compliance to any changes in terms of system parameters or process.
• Successfully pass the monthly audit sampling of own claims Candidate's Qualification:
• University degree in any discipline of Medical/MBBS specialization from a reputable university.
• 1 - 2 years of work experience in the Insurance industry is preferable but not mandatory.
• Excellent oral and written communication skills.
• Must be computer literate.
• Excellent command of the English language.
• Should be a team player with an aptitude for customer service. Must be service oriented.
• Highly decisive with outstanding logic and reasoning skills.
• Candidate must be tactful and discrete while dealing with Providers or Payers; must be able to handle confidential information.
• To approve reimbursement claims based upon member coverage & medical justification.
• To assist queries from providers and payers via phone calls or e-mails
• To maintain files for authorizations and other reports.
• Processing claims in line with the policy coverage and medical necessity
• Enter the record of daily intimation in Mobility for further process.
• Notify other companies for settlement of claims under their liabilities and follow up for timely settlement within stipulated time

RECRUITMENT 
QUALIFICATION : MEDICINE/MBBS

IELTS 7 BAND OR OET B BAND IN EACH SECTION

Healthcare/Hospital experience for 1-2 years, in departments such as Surgery, ICU or GP is required.

 

Skills Required