Role & responsibilities

1. IR Claims Follow-up & Calling Report: Followed up on all pending claims via email and calls. Updated the report with the latest status and defined the next steps for each case.
2. Daily Dashboard Report (OS): Working on the daily outstanding dashboard report.
3. Weekly Report: Preparing the weekly report to be shared with the client and broker.
4. Escalation Tracker: Maintaining the tracker daily. Interim responses are being sent and follow-up calls are being made until all escalations are closed.
5. Midterm Addition/Deletion Tracker: Maintaining the manual addition and deletion tracker.
6. Data Reconciliation: Reconciling unendorsed data and arranging the necessary endorsements.
7. Endorsement Updates & Claim Confirmations: Updating endorsements and confirming deletion claims.
8. Online Enrollment: Taking all necessary actions to complete the process.
9. Overall Outstanding Report: Preparing the comprehensive outstanding report covering cashless, reimbursement, and domiciliary claims.
10. Denial Review: Reviewing all pending denial claims internally for accuracy before sending them to the insurer.
11. Payment Bounce Claims: Following up with the insurer to reinitiate failed payments.
12.



DR & PDA Above 30 Days: Obtaining insurer approval to reject claims pending over 30 days.
13. Processed Claims Error Logs: Reviewing and resolving error logs for all processed claims.
14. Liability Check & Outstanding Investigation Claims: Following up to ensure investigations are completed and claims are processed within the SLA.
15. Monthly Claim MIS Report: On track to share the monthly report with the client and broker by the 1st, and with the insurer by the 5th of the month.
16. Outstanding Cashless Claims Follow-up: Coordinating with respective teams to track and ensure the closure and settlement of outstanding cashless claims.
17. Cashless Claims Summary: Preparing the overall summary of outstanding cashless claims for the weekly meeting discussion.
18. Call Management: Ensuring all calls are answered, including after hours and during weekends.
19. Email Turnaround: Ensuring all emails are responded to within 24 hours.
20. Stakeholder Meeting: Aligning with the broker, insurer, and client to discuss key claim issues, escalations, operational updates, and next steps.

📌 Crm Executive (Bengaluru)
🏢 Medi Assist
📍 Bengaluru