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Insurance Claim Processing Executive
2 weeks ago
**Job Duties & Responsibilities**
- Play as an intermediate role Between the Insurance co. and Hospital and the Team.
- Adjudicating cashless and Reimbursement claims with claim documents provided by help desk executive.
- Should be able to do claim tabulation to bifurcate payable and non-payable items as per the terms and conditions laid out in the insurance policy.
- Evaluating of claims and posting the remarks in what’s app group and updating in CRM.Monitoring billing as per the Tariff.
- Managing claims escalations form hospitals.
- Responsible to handling queries raised by insurance company / TPAs
- Provide technical assistance and to conduct training sessions for new processors on various health insurance policies.
- Evaluate complete claim documents before submission.
- Coordinate with Internal team to understand patient enquires.
- Helping team to understand the Non-medical Items.
- To create awareness about reimbursement claims. (Pre, Post & Hospitalization) and communicating the important updates to the Claims Assistance and Finance Department
- Be available at the office for supporting onsite staff on all six days in a week b/w 9.30am to 7.00pm
- Efficiently and effectively handle grievance / issue raised by hospital staff & patients, escalate issue to the team leader, Manager - Insurance Adjudication and Business Head as necessary.
- Follow-up on the updates to be given to the clients / onsite team of Claims Assistance Department
**Qualifications & Skills.**
- B-Pharma / D-Pharma
- 1 - 2 years of relevant experience
- Should have good analytical skills
- Excellent interpersonal & communication skills
**Experience.**
1 -2 years of experience in TPA or Insurance claims or similar field
**Additional Skills.**
- Strong verbal skills - Fluency in English & Kannada.
- Strong problem-solving skills and enthusiasm for new tasks and challenges
- Relationship building skills.
- Ability to multitask and prioritize, with a strong work ethic and attention to detail
- Ability to operate with a high level of confidentiality and professionalism
- Willingness to accept a high degree of uncertainty, jump in and help wherever needed, get hands dirty, and wear multiple hats on a fast-moving team.
- Should be able to manage the task assigned, while managing the tasks of the team/ team members that are assigned
- Should have an ability to manage and maintain smooth relationship with cross functional department such as Finance, Claims Assistance, Back-Office and Marketing Team
**Job Types**: Permanent, Fresher
Pay: ₹15,000.00 - ₹18,000.00 per month
Schedule:
- Day shift
- Morning shift
Work Location: In person
