Desktop investigation (Doctor)

1 - 5 years

0 Lacs

Posted:5 days ago| Platform: Shine logo

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Work Mode

On-site

Job Type

Full Time

Job Description

As a Claim Investigator at Star Health and Allied Insurance Co Ltd, your main responsibilities will include: - Conducting a thorough scrutiny of claim documents to ensure accuracy and completeness. - Matching the clinic findings mentioned in the ICPs/hospital documents with the customer during calls. - Identifying suspected cases and assigning them for investigation. - Ensuring that cases sent for investigation are closed within the defined turnaround time (TAT). - Maintaining a minimum hit rate of 30%. - Assisting desktop investigation staff in conducting claim investigations. - Actively participating in team meetings, sharing relevant information, and providing suggestions for process improvements. - Reporting risk information and findings to the immediate supervisor promptly. - Recommending new software tools for fraud detection, prevention, and reporting activities. Qualifications required for this role include BDS, MBBS, BHMS, BSMS, D PHARM, MDS, BPT, or MPT degrees. Additionally, candidates should have 1 to 3 years of experience in the health insurance industry. If you are interested in applying for this position, you can walk in directly from 7th July to 11th July at the following address: Star Health and Allied Insurance Co Ltd No. 15, Ground Floor, Sri Balaji Complex, Whites Lane, Royapettah, Chennai-600014 Landmark - Sathiyam Theatre Backside We look forward to welcoming qualified and dedicated individuals to join our team and contribute to our mission of providing exceptional health insurance services.,

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