Urgent Requirement For the Medical Advisor- Faridabad

☞ RAKSHA HEALTH INSURANCE TPA PRIVATE LIMITED

Ver: 107

Día de actualización: 06-05-2024

Ubicación: Faridabad Haryana

Categoría: Finanzas / Banco / Acciones Seguros

Industria: Insurance

Posición: Operations Manager

Tipo de empleo: Full Time, Permanent

Salario: ₹ 2,50,000 - 4,00,000 P.A.

Experiencia: 1 - 4 years

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Contenido de trabajo

Job Description:


Location- Faridabad


Qualification- BAMS, BHMS, BDS, Only

Position- Medical Advisor



ROLES AND RESPONSIBLTY-


Must have effective communication skills.

Candidate must have sound knowledge about claims hospitals and TPA.


Excellent diagnostic skills using clinical knowledge and x-rays.


Excellent knowledge about Insurance policy terms and conditions

Good knowledge about medical admissibility of claims

Good knowledge of clinical practices and protocols.

Excellent in terms of patient friendly.

Answering patient queries regarding status of claims

Answering queries regarding grievance requests raised by patients or hospitals.

Scrutiny of files to determine if the claims do really qualify to be reimbursed or to be settled.

To determine if the amount of the claims requested fits into SOC (Schedule of Charges) or PPN criteria

To verify if all the investigation reports have been submitted along with the claims

To make sure that intimation is received from the patient depending upon the type of claim i.e. cashless or non cashless (Claims Intimation)

To verify if all the document submission has been completed in time by t he patients(Claim Document Submission).

Interested candidates can send their resume at manoj.chander@rakshatpa.com

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Plazo: 20-06-2024

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