Primary Role Description
Responsible to Investigate Cashless/Spot and Reimbursement Claims in field.

Key Roles & Responsibilities:
Cashless & Spot cases need to be investigated within 24 hours from the allocation date.
Reimbursement cases need to be investigated within 15 days from the allocation date.
Pre Quality Check of Cashless and Reimbursement Claims for further investigation and Closure of his own cases.
Need to check Previous claims documents also before doing the investigation
Adhere to agreed TAT and accuracy
Should highlight Central team with Fraud Proven Hospital names on basis of his findings and market feedback.
Cases reports to be Prepared with Quality.
Maintain Daily Sheet of all the Investigation Cases
Coordination with within different function
Ability to work in highly competitive & demanding workplace

KEY STAKEHOLDERS
Internal: Customer Service and Operations Team

Claims Team

📌 Claim Facilitator Representative Field Operations Surat
🏢 Niva Bupa
📍 Surat