HR at Talent Integrators
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Assistant Manager - Claims Professional - Accident & Health Claims - Hospital - BAMS/BHMS/BUMS/MBBS/BDS (0-5 yrs)
Qualification: BAMS/BHMS/BUMS/MBBS/BDS
Job Description:
- Ensure accurate claim payout - 100% compliance.
- Being updated with policy terms and conditions to ensure prudent adjudication of claims.
- Attention to detail with regards to identification of fraud triggers in day to day claim processing.
- Verifying the tariff from providers in cashless payments.
- Logical and technical reasoning for high value claims.
- Ensure good inter and intra departmental rapport with all stakeholders to ensure seamless processing.
- Minimizing customer grievance by avoiding improper technical opinion.
- Being updated with the latest claim processing guidelines issued from time to time.
- Knowledge of day to day market trends in health Insurance, particularly in the line of claim processing.
- Stringent process related compliance ensuring the correct hospital details, member details and so on.
- Ensure compliance and adhering to defined turnaround time (TAT).
- All queries to be raised in one go barring exceptional claims or situations.
- All queries to be raised in one go barring exceptional claims or situations.
- Getting updated with latest developments in field of medicine & health insurance.
Skills Required:
- Knowledge of types of Hepatitis.
- Knowledge of types of Malaria.
- Knowledge of Dengue.
- Pre existing conditions of Body.
- Normal Platelets Count.
- Normal TLC Count.
- Knowledge of Stroke Symptoms and Diagnosis.
- Knowledge of Different Diseases Symptoms and Diagnosis
Salary: Upto 5 LPA
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