Assistant Manager

Medi Assist

4 - 5 years

3 Lacs

bengaluru

Posted:-1 days ago| Platform:

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Skills Required

bds bams bhms

Work Mode

Work from Office

Job Type

Full Time

Job Description

Roles & responsibilities

Serve as the primary medical point of contact for assigned corporate accounts, ensuring seamless communication and support.
Assess and understand client-specific healthcare requirements to customize Third-Party Administrator (TPA) services effectively.
Conduct regular account reviews and performance audits to monitor service quality and identify opportunities for improvement.
If any escalations come from the team in terms of wrong deductions or wrong quer's need to be reviewed and answer to the employee or broker accordingly, whenever if there is a meeting with the client, should visit and understand their requirements etc,.

Claims Review & Adjudication

Evaluate medical claims for accuracy, medical necessity, and adherence to policy guidelines.
Collaborate closely with claims processing teams to facilitate timely, fair, and complaint resolution of claims.
Provide expert medical opinions on complex or disputed claims, supporting informed decision-making.

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