31/01 Deepak Kumar
HR at Talent Integrators

Views:422 Applications:29 Rec. Actions:Recruiter Actions:0

Assistant Manager - Claims Professional - Accident & Health Claims - Hospital - BAMS/BHMS/BUMS/MBBS/BDS (0-5 yrs)

Noida Job Code: 9003

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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