Coordinate desk operations for Third-Party Administrators (TPA), Government Health Schemes (ECHS), and major insurance providers.
Patient Guidance &
Processing:
Assist patients with cashless pre-authorization, eligibility checks, claim submission, and query resolution for ophthalmic procedures.
Documentation &
Billing:
Prepare, review, and upload accurate clinical and billing documentation (discharge summaries, diagnostic reports, and procedure notes) to ensure timely approvals.
Claim Settlement &
Reconciliations:
Track claim statuses, resolve rejections/shortfalls, and coordinate with finance for timely payment reconciliation.
Compliance &
Coordination:
Ensure strict adherence to NABH standards, ECHS guidelines, and insurer-specific protocols