Mediclaim Executive

Specific Job Responsibilities 1. Explaining the concept of cashless & reimbursement to the patient & relatives 2. Filling Pre Auth forms. 3. Collecting all essential documents at the time of Admission. 4. Providing details/ information to the Billing/ Ward billing staff. 5. Faxing / Mailing documents as per requirement. 6. Taking continuous follow up for all the cases depending upon dire emergency for all admitted cases. 7. Informing all approval, Denial, Interims, Queries & final bill enhancements. 8. Reverting to the mails of TPA regarding cashless claims. 9. Checking any bill exceeding the authorized amount & forwarding interim bills. 10. Making check list for any short of documents of the admitted patient. 11. Co-ordinate with All TPAs, insurance companies and corporate. 12. Informing & counselling regarding the concepts of c0-payment/ Administrative charges /Non payable items deducted by TPA. 13. Explaining inclusions/ Exclusions in the policies. 14. Calculating exact deducted amount by the TPA / Insurance companies. 15. Discharging patient after completion of all the formalities. 16. Changing the bills from cashless to self-pay in case of denial. 17. Informing the list of planned admission to the admission department with details of the patients. 18. Bed release of discharged patient 1. Behavioral Competencies: Proactive Problem solving ability. Result oriented Good co-ordination skills Interested Candidates can share you updated resume on recuitment@noblehrc.com