Medical Officer – TPA Claim Process

**Role : Medical Officer - CLAIM PROCESSING** 1.Medical Scrutiny by thorough assessment of documents. 2.Provide Medical opinion on admissibility of Insurance Claims. 3.Proficient with medical terms & system. 4.Understanding of Policy terms & conditions with their practical applicability & Various Protocols / Guidelines. 5.Understanding of Claims...

Role : Medical Officer - CLAIM PROCESSING1.Medical Scrutiny by thorough assessment of documents.2.Provide Medical opinion on admissibility of Insurance Claims.3.Proficient with medical terms & system.4.Understanding of Policy terms & conditions with their practical applicability & Various Protocols / Guidelines.5.Understanding of Claims adjudication / Claims...

Key Responsibilities as follows: **1*.**Patient Coordination.* **2. Claims Processing Oversight.** **3. Daily morning round to assess gaps and their resolution.** **4. Relationship Building.** **5. Data Analysis and Reporting.** **6. Compliance Management.** **7. File management.** **8. Continuous Training to RMO & Nursing Officer.** **9. Claim...

Key Responsibilities as follows: **1*.**Patient Coordination.* **2. Claims Processing Oversight.** **3. Daily morning round to assess gaps and their resolution.** **4. Relationship Building.** **5. Data Analysis and Reporting.** **6. Compliance Management.** **7. File management.** **8. Continuous Training to RMO & Nursing Officer.** **9. Claim...

Role OverviewThe TPA Manager will be responsible for overseeing all operations related to private insurance, TPAs, and government health schemes including Bhamashah Swasthya Bima Yojana (BSBY) and Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY). The role ensures smooth cashless and reimbursement processes, timely approvals, and compliance with all...

**Role Description** This is a full-time on-site role for a TPA Executive at East Delhi Medical Centre. The TPA Executive will be responsible for handling third party administration activities, coordinating with insurance companies, verifying patient insurance coverage, and ensuring timely reimbursements. **Qualifications** - Knowledge of Third Party...

Job profile: TPA CLAIM PROCESSING helpdesk. We need people only from TPA Insurance Companies who has worked as a CRM helpdesk.(compulsory) Job Description  CRM implants for claim support at client location  Resolve customer queries on policy coverage and health claim processes  Facilitate to drive claims app for submission and tracking of claims by...

Urgent Hiring For TPA Executive Urgent Hiring for TPA Executive Profile - TPA Executive Salary - 20K to 25K Experience - 3 to 7 Years Location - Karol Bagh, Delhi Qualification - Any Graduate / Post Graduate JD - Patient Handling Query reply, document submission intimation to TPA, Day to day tracking of each claim and process for approval, Having...

Urgent Hiring for TPA Executive. Job Description is as follows: - Manage the entire operation of Front Office which includes Admission, help desk, Billing & TPA department. - Development and continuous process of revision of guidelines of Front Office, Registration, Billing, admissions, TPA and other activities. - Manage Insurance cashless pre-authorization...

Looking for TPA doctors ( General Medicine) Experience: 5+ years post MBBS Responsible for overall medical documentation related to TPA processes of the patients at various stages starting from preauthorization form till post discharge queries. TPA doctor will liaison with various specialty consultants to ensure quick and appropriate reverts to the TPA...