Insurance Executive

3 weeks ago

Angamali KL IN RCMASSIST HEALTHCARE SOLUTIONS PRIVATE LIMITED Full time

KEY INTERNAL INTERACTION WITH NATURE OF INTERACTION Accounts Finance Submitting and following up of claims settlement and maintaining claims MIS with settlement details Operations Managing front office staff for Govt credit business- ESI ECHS Govt Schemes and facilitating for the cashless provisions to patients as per eligibility and norms Assemble and maintain patient records review transcriptions and interact with Physicians to ensure all relevant patient information are recorded for submission to authorities Coordinating cashless request medical query Arbitration with medical teams- both internal and external Ensuring for approvals on credit facility for scheme patients and settlement after final approval claim payment receipts Maintaining MIS of credit patients including admissions cashless submissions payment settlement status Ensure timely preparation of claim document and submission with respective authorities Managing the timely revert on medical nonmedical financial queries on submitted cashless claims Coordinating for the surgery OT clearance based on initial approvals or advance deposits Obtaining patient feedback from credit patients tie up departments KEY EXTERNAL INTERACTION WITH NATURE OF INTERACTION Patients Insurance Co TPAS ESI ECHS Medical Team Answering Patient Billing queries work with patients and government authorities to get claim processed and paid Liaisoning with Insurance authorities for claim payments queries rejection arbitrations Objective This role incumbent is responsible is to work closely with the Insurance ESI ECHS Beneficiaries to ensure timely processing of cashless admissions and submission settlement of Cashless claims Key Responsibilities 1 Preparation Processing of Health Insurance Cashless Claims Submitting and following up of claims creating and Managing cashless Patient files including admission requests extended stay approvals Additional approvals etc Reviewing appealing unsettled patient claims - Query Arbitration Management Adherence to TAT of admissions approvals and bill submission settlement 2 Operational Activities Facilitating for Account receivable reports and coordinate with finance TRM for account receivables management Provide feedback of claims status to the reporting officer on a daily weekly basis Job Type Full-time Pay 13 000 00 - 18 000 00 per month Benefits Cell phone reimbursement Experience total work 2 years Preferred Work Location In person Expected Start Date 13 10 2025

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