Claim Facilitator Representative- Senior Executive/Assistant Manager

1 - 4 years

3 - 5 Lacs

Posted:9 hours ago| Platform: Naukri logo

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Work Mode

Work from Office

Job Type

Full Time

Job Description

*HJealth insurance Open position*

Location

Bangalore-1

Hyderabad-2

Chennai-1

*CTC: Upto 5.0 LPA*

Age: Max 35

JOB PROFILE

Position - Claim Facilitator Representative- Senior Executive/Assistant Manager

JOB SUMMARY:

  • Responsible to Investigate Cashless/Spot and Reimbursement Claims in field.

KEY RESPONSIBILITIES:

  • Cashless & Spot cases need to be investigated within 24 hours from the allocation date.
  • Reimbursement cases need to be investigated within 15 days from the allocation date.
  • Pre Quality Check of Cashless and Reimbursement Claims for further investigation and Closure of his own cases.
  • Need to check Previous claims documents also before doing the investigation
  • Adhere to agreed TAT and accuracy
  • Should highlight Central team with Fraud Proven Hospital names on basis of his findings and market feedback.
  • Cases reports to be Prepared with Quality.
  • Maintain Daily Sheet of all the Investigation Cases
  • Coordination with within different function
  • Ability to work in highly competitive & demanding environment

KEY STAKEHOLDERS

Internal:

  • Customer Service and Operations Team
  • Claims Team

MEASURES of Success:

  • Fraud Proven %
  • TAT
  • Quality of investigation
  • Productivity

QUALIFICATION & EXPERIENCE:

  • Any Graduate from any Background (Medical Background Preferred)
  • 1-2 Years Experience in Field Investigation
  • Knowledge of Insurance Industry
  • Knowledge in Computer & MS Office
  • Excellent Interpersonal and team working skills

KEY COMPETENCIES & SKILLS REQUIRED

  • Investigation skills
  • Knowledge of Insurance

* For More Details, Contact:*

Ishika (HR) – 9893092836

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