Customer Service Manager - Health Claims

2 - 4 years

3 - 4 Lacs

Posted:1 day ago| Platform: Naukri logo

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Work Mode

Work from Office

Job Type

Full Time

Job Description

for Health Reimbursement Claims Processing doctor.

  • Medical Evaluation and Documentation

  • Examine claim documents and understand detailed clinical findings.
  • Document diagnoses, treatment plans, and procedures done clearly.
  • Ensure medical records are accurate and complete for claim submission.
  • Certification and Verification

  • Certify the necessity of treatments or procedures for insurance claims.
  • Verify the authenticity of medical reports submitted for claims.
  • Provide second opinions or independent medical examinations (IME) when required.
  • Compliance and Ethical Oversight

  • Ensure all documentation and certifications comply with regulatory and insurer policies.
  • Prevent and report fraudulent claims or misrepresentations.
  • Advisory Role

  • Advise insurance companies on complex medical cases or disputed claims.
  • Participate in claim review committees or panels if needed.

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ICICI Lombard logo
ICICI Lombard

Insurance

Mumbai

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