- Working directly with the insurance company, healthcare provider, and patient to get a claim processed and paid
- Handling all pre-authorization approval under Insurance Policy.
- Re-solving the query related to Hospital & Customers.
- Handling and Re-confirming all incoming & outgoing E-mails.
- Follow up of documentation of above procedures and registers.
- Handling the pre approval procedure according to Insurance & TPA MOU and others.
- Handling final proceedings of Insurance Company bills.
- Handling Corporate Clients under Insurance Policy.
- Collecting the information required to create a claim
- Reviewing and appealing unpaid and denied claims. Completion of documentation and sending the same to the Insurance ,TPA and corporate for processing.
- MIS Reports
- Participate in Audit, and other training and development as required.
- To participate in the appraisal scheme in accordance with Hospital policy