Claim Processing Doctor - Insurance - MBBS/BAMS/BHMS (1-10 yrs) Hyderabad (Doctor) in Hyderabad, Andhra Pradesh for sale

We have an urgent opening for one of the best Insurance sector, based out of Hyderabad. Company- Insurance Position- Claim Process Doctor Location- Gachibowli, Hyderabad ExpMin 1 yr Qualification- MBBS, BAMS, BHMS - Claims management processes e.g. authorization, adjudication, verification, audit etc. - Evaluation of Treatment & Associated Costs - Evaluation of Health Claims Ratio Interaction with Health Care Provider - Coordination with internal & external teams - Implement new process to cut down on cost and improve client service Have to handle Critical Illness Claims, Team Management, Report Generations, Analytics, Process Management & Innovation, Maintaining and setting industry benchmarks, Project identification and implementation. - Processing Mediclaims in Cashless. & Authorization. - Issuing RAL/DAL/Queries/ADR during processing of mediclaims. - Knowledge of ICD . - Scrutiny, verification and cross checking of medical claims so that only liable claims can proceed. - In person visits to the hospitals concerned for checking the reality status of the claims. - Coordination with the medical faculty in the final approval of the claim & Query resolving regarding mediclaims. - Maintaining TAT of the claim processing . - Handling the grievance call of the claimants & Hospitals & delivering technical answers. - Quality check of Medical Reports & Bills submitted for processing. - Rating the Empanelled Hospital as per their Merits. (ref:biojoby.com)