Posted:8 hours ago|
Platform:
Work from Office
Full Time
• Processing of health claims as per SOP/guidelines shared,
• Day to day achievement of expected productivity with out compromising on the quality parameters.
• Identification of Fraud triggers and possible leakage
• Complete understanding of health claims processing
• Aware of latest regulations and its implications
• Adherence to the prescribed TATs for each category
• Thorough medical knowledge, clinical efficacy of the treatment protocols given
• Able to read, interpret and question the information on the medication and relation to the diagnosis
• Clear understanding on ICD code and procedure codes
• Case management where there is possibility of inflation/abuse
• Interpretation of the product wordings for appropriate claims decision
Digit Insurance
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