TPA Executive

1 day ago

Gurugram, India ClaimBuddy Technologies Pvt Ltd Full time

Job Designation-: Insurance TPA, Claim Specialist

Roles & Responsibilities-:

  • Candidates should have worked in Hospital Insurance desk (Most Important)
  • Provide Medical opinion for Health Insurance Claims
  • Processing of Cashless Requests & Health Insurance Claim Documents
  • Proficient with medical terms & system.
  • Understanding of Policy terms & conditions & Various Protocols / Guidelines
  • Understanding of Claims adjudication / Claims Processing
  • Maintaining & Ensuring Standard Operating Procedures & Protocols
  • Ailment Wise ICD & Procedure Coding
  • Manage volumes effectively & efficiently to maintain Turnaround time of processing cases
  • VIP Claims Processing and TAT Maintenance
  • Claim Case Management / Cost Management

Requirements-:

  • At least 2-3 yrs experience in Medical Officer Claims Processing Cashless/Reimbursement cases in any hospital
  • Good Excellent oral and written communication, negotiation and decision-making skills.
  • Good customer service/relationship skills and ability to work effectively in a fast-paced environment with shifting priorities.

Immediate Joiner

Job Type: Permanent

Pay: ₹18, ₹27,862.52 per month

Benefits:

  • Health insurance
  • Provident Fund

Experience:

  • total work: 1 year (Preferred)

Work Location: In person

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