Role: Hospital Administrator

Type: Full Time

Job Description

Roles and Responsibilities

- Ensure an effective and efficient Claims facilitation process and accountable for appropriate job allocation and coordination amongst the team.

- Monitor the productivity of the Data Management Services team by ensuring that Claims (cashless /reimbursement) received at Branch/Zone are uploaded on daily basis along with the important documents.

- Monitor escalations from customers/clients being reported by interacting with respective Zonal/Corporate Medical team and ensure grievance process is precisely implemented by the nominated grievance officers.

- Supervising and monitoring all legal issues relating to claims including Ombudsman /Consumer forum.

- Effectively communicate claim control measures to the Operating Offices and ensure that they are implemented.

- Keep track on sudden inflow of claims from any particular non-tertiary care hospitals and try to get confidential report about such hospitals and keep the Vigilance team informed.

- Hold regular meeting of TPA desk officers of Network hospitals.

- Monitor total cash-flows to hospitals and ensure that we get maximum early payment discount / avoid no penal interest paid for delayed payments.

- Keep track on working of FVR activities and ensure that same FVR doctor is not sent regularly to any one hospital.

- Attend meeting with various Marketing teams to understand market trends/customer grievances/ and ensure they are addressed.

- Coordinate with CMU for any underwriting related issues escalated to Zonal Office.

- Periodic meeting with Regional Vigilance Officers and guide them on carrying out effective investigation.

- Any other responsibility as deemed fit by the Management.

This job opening was posted long time back. It may not be active. Nor was it removed by the recruiter. Please use your discretion.