Job DescriptionJob Location: - Western Line in Mumbai
nPrimary Role Description: -
nResponsible to Investigate Cashless/Spot and Reimbursement Claims in field.
nKey Roles & Responsibilities:
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- 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 investigationn
- Adhere to agreed TAT and accuracyn
- 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 Casesn
- Coordination with within different functionn
- Ability to work in highly competitive & demanding workplacen
nKEY STAKEHOLDERS
nInternal:
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- Customer Service and Operations Teamn
- Claims Teamn
nEducation
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- Any Graduate from any Background (Medical Background Preferred)n
nExperience
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- 1-2 Years' Experience in Field Investigationn
- Fresher can also be consider with Medical Knowledge but willing to work in field.n
- Knowledge of Insurance Industryn
- Knowledge in Computer & MS Officen
- Excellent Interpersonal and team working skilln