Key Responsibilities
To ensure 100% compliance on claim processing through IHX portal.
Monitor complete end to end cycle on claim management, disbursal and settlement.
Daily, weekly and monthly review of claim raised, under query, pending/disputed and ageing of the same.
To assist the local TPA team for any claims which are stuck due to unresolved query or which are disputed for various reasons.
To ensure final settlement of claims as per agreed MOU with the partners and corporates.
To monitor and control disallowances & short payments post final approval.
Monitor and supervise process of claims settlement in HMIS.
Liaise, engagement and coordinate for Insurance companies and TPA partners
To address/coordinate/resolves claims which are exceeding > 60 days’ window of settlement.
📌 Head Tpa & Insurance Pune (India)
🏢 Jupiter Hospital
📍 India
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