I am seeking a well-developed organization with a dynamic working environment, where I can utilize my expertise and do smart work. I also want to learn more and more by hard working. I’ll be happy to be a part of your smart & hard-working team.
Enter Description
Maintain MIS for Claims for Internal Consumption.
Manage all claim documents QC.
Timely follow up with clients for claim requirement Queries.
Timely Follow up with insurance companies for claim.
Manage all settlement / requirement issues.
Scanning and Dispatching for claim Documents.
Scheduling of company rider for various pickups related to claims.
Maintenance of Courier record for claims.
Any other task assigned by Line Manager/ HOD / Management.
OPD- Calims Live Chat support.
Evaluates and processes claims in accordance with insurance policy terms and conditions, company policies and procedures according
to productivity and quality standards.
Ensures that targets are met for department turn around time, quality and productivity.
Identify and report back any type of claims observation or issues that may affect the process.
Collect and analyze claims data to identify and resolve errors, delayed claims, and processing issues.
Providing recommendations to take steps to improve the claims processing quality standards and productivity.
Analyze reports from the administrative software for provider and member utilization trends and identification of areas requiring further
management.
Support the Team Leader /Manager in implementation of quality assurance programs in order to maintain standards of quality and
minimize fraudulent cases.
Handling medical approval-related call queries .
Maintain confidentiality with regard to the information being processed, stored or accessed.
Completes other projects and duties as assigned.