Job Description Job Location: - Western Line in Mumbai
n Primary Role Description: -
n Responsible to Investigate Cashless/Spot and Reimbursement Claims in field.
n Key Roles & Responsibilities:
n n Cashless & Spot cases need to be investigated within 24 hours from the allocation date.
n Reimbursement cases need to be investigated within 15 days from the allocation date.
n Pre Quality Check of Cashless and Reimbursement Claims for further investigation and Closure of his own cases.
n Need to check Previous claims documents also before doing the investigation
n Adhere to agreed TAT and accuracy
n Should highlight Central team with Fraud Proven Hospital names on basis of his findings and market feedback.
n Cases reports to be Prepared with Quality.
n Maintain Daily Sheet of all the Investigation Cases
n Coordination with within different function
n Ability to work in highly competitive & demanding setting
n n KEY STAKEHOLDERS
n Internal:
n n Customer Service and Operations Team
n Claims Team
n n Education
n n Any Graduate from any Background (Medical Background Preferred)
n n Experience
n n 1-2 Years' Experience in Field Investigation
n Fresher can also be consider with Medical Knowledge but willing to work in field.
n Knowledge of Insurance Industry
n Knowledge in Computer & MS Office
n Excellent Interpersonal and team working skill
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