1 - 3 years
3 Lacs
Posted:2 days ago|
Platform:
Work from Office
Full Time
- Develop a medical provider network by strategically negotiating contract constraints.
- Leveraging insurance contracts with quality healthcare providers for optimal financial results.
- Development policy guidelines for the empanelment of Hospitals and healthcare providers
- Negotiation and empanelment of different types of providers.
- Reach out to health delivery systems and evaluate their services based on company mandated criteria.
- Ensure compliance with contract guidelines, preparing financial projections, overseeing insurance claims for accuracy.
- Customizing fee schedules, attending provider review meetings, and reporting to leadership.
- Investigate, evaluate, and post applying technical knowledge, monitor the performance of all the providers.
- Resolve complex negotiations and terms with the network providers and get the best deal for the organization.
- Collaborate with internal teams and other intermediaries to ensure faster claim settlement, ensuring good customer experience
- Communicate with the customer care team for timely resolution of customer queries driving customer satisfaction.
2-3 Years Work experience in the provider department of a Third-Party Administrator (TPA), inhouse setup of any general / standalone health insurance company
Work experience in any hospital insurance department can also be considered with adequate knowledge of hospital tariff making process. Strong communication and negotiation skills.
Good contacts with hospitals in the allocated geographical area. Willing to travel extensively in the allocated geographical area
SBI General Insurance
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