RCMASSIST HEALTHCARE SOLUTIONS PRIVATE LIMITED

JOB INTERACTIONS NATURE OF INTERACTION Insurance Coordination Cashless Desk Management at associated hospitals TPA/Insurance patient co-ordination and documentation /counselling Assemble and maintain patient records, review transcriptions and interact with Associated Hospitals to ensure all relevant patient information are recorded for submission to Insurance companies. Ensure timely preparation of cashless claim document and submission with respective insurance TPAs Coordinating for cashless claim queries on submitted claims and submitting query reply within TAT Ensuring for Cashless MIS from associated hospitals Maintaining MIS of credit patients including admissions/cashless/submissions Accounts Receivables Follow UP Hospital Empanelment Job Type: Full-time Pay: ₹12,000.00 - ₹25,000.00 per month Schedule: Day shift Supplemental Pay: Performance bonus Ability to commute/relocate: Ernakulam, Ernakulam - 682018, Kerala: Reliably commute or planning to relocate before starting work (Required) Experience: total work: 1 year (Preferred) Application Deadline: 17/06/2025 Expected Start Date: 20/06/2025

JOB INTERACTIONS NATURE OF INTERACTION Insurance Coordination Cashless Desk Management at associated hospitals TPA/Insurance patient co-ordination and documentation /counselling Assemble and maintain patient records, review transcriptions and interact with Associated Hospitals to ensure all relevant patient information are recorded for submission to Insurance companies. Ensure timely preparation of cashless claim document and submission with respective insurance TPAs Coordinating for cashless claim queries on submitted claims and submitting query reply within TAT Ensuring for Cashless MIS from associated hospitals Maintaining MIS of credit patients including admissions/cashless/submissions Accounts Receivables Follow UP Hospital Empanelment Job Type: Full-time Pay: ₹12,000.00 - ₹25,000.00 per month Schedule: Day shift Supplemental Pay: Performance bonus Ability to commute/relocate: Ernakulam, Ernakulam - 682018, Kerala: Reliably commute or planning to relocate before starting work (Required) Experience: total work: 1 year (Preferred) Application Deadline: 17/06/2025 Expected Start Date: 20/06/2025

Desired Qualification: BDS/BAMS/BHMS The Insurance Medical Officer (IMO) is a key member of the Insurance Team responsible for the servicing of Patients from Insurance, ESI, ECHS The MIO will provide opinions and recommendations in the co-ordination of medical case management. This relates to broad medical issues including liaising with treating medical officers. The MIO will be involved in the assessment of complex claims cases to ascertain pre existing elements and validity of the claim. The MIO will provide support to the insurance division in the assessment of cancellation claims and the provision of medical reports and will also provide medical assessment for Insurance ,ESI and ECHS cases where required, as per direction from the Hospital Authorities. Technical/Functional Competency: · Should demonstrate excellent inter-personal and communication skills, and be able to communicate in a way which assists understanding. · Should be certified to provide BLS. Must have a working knowledge of the use of personal computers. · Examine the patients, and record the history in EMR, in a safe, compassionate and ethical manner and in compliance with Good Medical Practice. · Request investigations, and record the results in the medical chart. · Conduct daily ward rounds, and record the notes about patient progress and health status. · Work according to the management plan approved by the registrar / consultant in-charge · Work as a team member during the on-call duties to ensure organization of comprehensive patient management. · Assist senior members of the team in performing invasive procedures. · Handle common clinical scenarios and emergency situations such as, cardio-pulmonary resuscitation, and then communicate with the senior members of the team. · Liaise with the clinical services committee of the department. · Maintain accurate medical records. · Adhere to quality indicators, TAT and protocols for the dept. · Adhere to prescribed infection control standards · Ensure that medical information provided in cashless documents are correct and not contradictory or all relevant information including patient history/preexisting conditions are presented in request form/Case sheet/discharge summary/query response etc. · Support the billing team in selecting surgery packages · Ensure claims are approved and settled , chances for queries or rejections during settlement to be avoided and high value claims or package deviations are stated with supporting OT notes /progress notes etc · Oversee the department al functioning report to Head Medical services on operational lags/issues/ patient grievance /staff performance etc · Provide MIS – Daily/weekly/monthly · Identify areas of process optimization · Ensure timely documentation and submission of reports · Ensure that there are no medico legal issues due to errors and negligence in the dept. In case of such issues, take complete ownership to resolve the matter · Ensure to keep abreast with latest developments in his/her area · Demonstrate evidence of successful participation in mandatory courses required by the Hospital. · Participate in the training activities Job Type: Full-time Pay: ₹15,000.00 - ₹18,000.00 per month Schedule: Day shift Supplemental Pay: Performance bonus Education: Bachelor's (Required) Experience: total work: 1 year (Preferred) Management: 1 year (Preferred) Work Location: In person Application Deadline: 17/06/2025 Expected Start Date: 20/06/2025

KEY INTERNAL INTERACTION WITH NATURE OF INTERACTION · Accounts & Finance Submitting and following up of claims settlement and maintaining claims MIS with settlement details · Operations Managing front office staff for Govt. credit business- ESI/ECHS /Govt. Schemes and facilitating for the cashless provisions to patients as per eligibility and norms. Assemble and maintain patient records, review transcriptions and interact with Physicians to ensure all relevant patient information are recorded for submission to authorities. Coordinating cashless request/medical query/Arbitration with medical teams- both internal and external Ensuring for approvals on credit facility for scheme patients and settlement after final approval/claim payment receipts. Maintaining MIS of credit patients including admissions/cashless/submissions/payment settlement status Ensure timely preparation of claim document and submission with respective authorities. Managing the timely revert on medical/nonmedical /financial queries on submitted cashless claims Coordinating for the surgery/OT clearance based on initial approvals or advance /deposits. Obtaining patient feedback from credit patients & tie up departments KEY EXTERNAL INTERACTION WITH NATURE OF INTERACTION · Patients/ Insurance Co./TPAS/ESI/ECHS /Medical Team Answering Patient Billing queries, work with patients and government authorities to get claim processed and paid. Liaisoning with Insurance authorities for claim payments/queries/rejection/arbitrations Objective This role incumbent is responsible is to work closely with the Insurance /ESI/ECHS/Beneficiaries to ensure timely processing of cashless admissions and submission/settlement of Cashless claims Key Responsibilities 1 Preparation & Processing of Health Insurance/ Cashless Claims · Submitting and following up of claims, creating and Managing cashless Patient files including admission requests/extended stay approvals/Additional approvals etc. · Reviewing & appealing unsettled patient claims - Query & Arbitration Management · Adherence to TAT of admissions , approvals and bill submission & settlement 2 Operational Activities · Facilitating for Account receivable reports and coordinate with finance/TRM for account receivables management · Provide feedback of claims status to the reporting officer on a daily/weekly basis Job Type: Full-time Pay: ₹12,000.00 - ₹15,000.00 per month Benefits: Cell phone reimbursement Experience: total work: 1 year (Preferred) Work Location: In person Expected Start Date: 01/09/2025

KEY INTERNAL INTERACTION WITH NATURE OF INTERACTION · Accounts & Finance Submitting and following up of claims settlement and maintaining claims MIS with settlement details · Operations Managing front office staff for Govt. credit business- ESI/ECHS /Govt. Schemes and facilitating for the cashless provisions to patients as per eligibility and norms. Assemble and maintain patient records, review transcriptions and interact with Physicians to ensure all relevant patient information are recorded for submission to authorities. Coordinating cashless request/medical query/Arbitration with medical teams- both internal and external Ensuring for approvals on credit facility for scheme patients and settlement after final approval/claim payment receipts. Maintaining MIS of credit patients including admissions/cashless/submissions/payment settlement status Ensure timely preparation of claim document and submission with respective authorities. Managing the timely revert on medical/nonmedical /financial queries on submitted cashless claims Coordinating for the surgery/OT clearance based on initial approvals or advance /deposits. Obtaining patient feedback from credit patients & tie up departments KEY EXTERNAL INTERACTION WITH NATURE OF INTERACTION · Patients/ Insurance Co./TPAS/ESI/ECHS /Medical Team Answering Patient Billing queries, work with patients and government authorities to get claim processed and paid. Liaisoning with Insurance authorities for claim payments/queries/rejection/arbitrations Objective This role incumbent is responsible is to work closely with the Insurance /ESI/ECHS/Beneficiaries to ensure timely processing of cashless admissions and submission/settlement of Cashless claims Key Responsibilities 1 Preparation & Processing of Health Insurance/ Cashless Claims · Submitting and following up of claims, creating and Managing cashless Patient files including admission requests/extended stay approvals/Additional approvals etc. · Reviewing & appealing unsettled patient claims - Query & Arbitration Management · Adherence to TAT of admissions , approvals and bill submission & settlement 2 Operational Activities · Facilitating for Account receivable reports and coordinate with finance/TRM for account receivables management · Provide feedback of claims status to the reporting officer on a daily/weekly basis Job Type: Full-time Pay: ₹12,000.00 - ₹15,000.00 per month Benefits: Cell phone reimbursement Experience: total work: 1 year (Preferred) Work Location: In person Expected Start Date: 01/09/2025