
Health Claim processing ll Mumbai
1 week ago
Role & responsibilities
- Processing of pre-authorization/cashless claim.
- Maintain processing TAT for pre-auth/cashless claim
- Must be able to analyze large amount of data, Identify patterns and draw conclusions from that data
- Must have previous experience of conducting audit, sampling and preparing reports
- Reviewing insurance policy documents to determine coverage limits, exclusions that may affect the claim.
- Reviewing medical bills, medical records, and other documentation to determine medical necessity and appropriate treatment.
Preferred candidate profile
- Any Medical degree (Mandatory)
- Good communication skills
- Ability to multi-task
- Good interpersonal skills
- Should know internal systems
- Good understanding of processes
- Problem Solving ability and Positive Attitude
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