TPA Senior Executive

2 days ago


Gurgaon, Haryana, India ClaimBuddy Full time ₹ 8,00,000 - ₹ 12,00,000 per year

Roles & Responsibilities-:

·      Candidates should have worked in the Hospital Insurance desk (Most Important)

·      Provide Medical opinion for Health Insurance Claims

·      Processing of Cashless Requests & Health Insurance Claim Documents

·      Proficient with medical terms & systems.

·      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 the 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


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