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Assistant Manager - TPA

Assistant Manager - TPA

Fortis

4 - 8 years

4 - 6 Lacs

noida

Posted:16 hours ago| Platform:

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Skills Required

tpa

Work Mode

Work from Office

Job Type

Full Time

Job Description

Ensuring timely completion of all internal deliverables and maintaining MIS, reports, etc for management information purpose.
Handling investigation and fraud detection in health and personal accident claims.
Responsible for maintaining strong relationship with TPA and Insurance Companies.
Liaison for smooth flow of pre-authorization request for all corporate and retail health policies
Liaison for effective cashless and reimbursement claim process
Liaison with external TPAs for timely processing of cashless and reimbursement claims
Involved in TPAs claims audit and maintaining Service Level Adherence with them
Monthly claims review meeting with clients & TPA’s.
Handling settlement TAT’S
Monitoring of retrieval claims, and quality control
Monitoring TPA’s function to ensure quality & accuracy in cashless & reimbursement claim settlement
Strictly maintaining Service Level Adherence and complaint management with the teams end with good and timely coordination
Handling all audits internal or client requested

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Assistant Manager - TPA