Urgent Requirement For the Medical Advisor- Faridabad
☞ RAKSHA HEALTH INSURANCE TPA PRIVATE LIMITED
View: 107
Update day: 06-05-2024
Category: Finance / Bank / Stock Insurance
Industry: Insurance
Position: Operations Manager
Job type: Full Time, Permanent
Salary: ₹ 2,50,000 - 4,00,000 P.A.
Experience: 1 - 4 years
Job content
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
Deadline: 20-06-2024
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