Walk-in-Interview For B Pharma & MBA For Health Administrative Depart
Job description
JOB DESCRIPTION:-
Claim registration - On Daily Basis need to register the claims which has been assigned for processing, Scrutiny of the documents NEFT Updation - Updation of customer/insured NEFT details on the system while processing the claims
Reserve Setting:- Need to do the proper reserve setting on a system based on the claim documents
Technical processing claims which has been assigned for processing for health/ personal accident etc claims and deductions of Non-Medical charges, Standard deductions of co-payment as per the policy terms and conditions - On Daily basis need to do technical Assessment of the claims post registration of the claim which include billing of the claim as per the respective heads, Data Entry as per the standard fields in system, Deductions of non-Medical Charges as per the standard IRDAI list, Co-Payment deductions as per the policy terms and condition/ Benefit charts, etc.
Medical Processing Claims which has been assigned for processing for health/OPD/Personal Accident etc./ finalize the Medical Admissibility of claims, Deduction of Medicine expenses those are not related to claim/ICD/PCS code implementation against the claim
Quality Review/Open/Close claims On Daily basis need to review the claims and process the deficient claims those has been assigned, On Quality Review need to review the open claims and need to process those can we processed on Available documents
Co-ordination with Branch Offices/Clients/Hospitals for requirements - Need to have followed up with branches office/clients/hospitals for additional documents whenever require
Traveling/Relocation - Candidate should be open for traveling whenever require for official work and also ready to relocate based on the organization or business requirement.
Eligibility Criteria:-
- Should have a fair knowledge of health insurance and have a fair knowledge of health Products and Personal Accident products
- Good Communication Skill -Read, Write and Speaking
- Good Knowledge of MS Office/Excel/Powerpoint
Education Qualification:-
- Person Should have a valid degree as mentioned below:-
B. Pharma
MBA
Perks and Benefits
Bonus
Experience: 1 - 3 years,
Location: Pune( Viman Nagar).
Role: Claims Executive
Industry Type: Insurance
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