Medical Officer/Sr. Medical Officer Family Health Plan (FHPL)

0.0 years

4 - 6 Lacs

Pune, Bengaluru, Mumbai (All Areas)

Work from Office

Role & responsibilities To give Claims & Cashless/preauthorization, and scrutiny Medical Reimbursement Claims, and to Process Claims Third Party Administration (Health) services (TPA) Claims and Preauthorization Processing HealthCare Assistance Services High Ratio Claims Management in coordination with Networking and Empanelment Department Monitoring the overall operations of Claims and Preauthorization. Responsible for ensuring efficient response at the level of Preauthorization to maintain TAT. Ensure adherence to processes and controls. Creating the process for claim processing (Cashless and Reimbursement). Co-ordination between Network Hospitals/Preauthorization/Claims. Ensuring a high-quality patient care at customized/optimized cost. Creating the process for claim processing (Cashless and Reimbursement). Preferred candidate profile • Good Excellent oral and written communication, negotiation, and decision-making skills. • Good customer service/relationship skills and ability to work effectively in a fast-paced environment with shifting priorities . Must be willing to work in non - clinic TPA EXPERIENCE mandatory. Clinical Exp.

Posted 2 weeks ago

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