14 Nov
|
Han Digital Solution
|
Bengaluru
14 Nov
Han Digital Solution
Bengaluru
- Assess complex medical claims similar to AXA, AIA, Alliance Care
- Verify medical codes, diagnosis and procedure to ensure compliance with industry standards (eg ICD 9, ICD 10, CPT)
- Review Clinical & Day Case claims and approve/reject basis the SOP
- Review Hospital Inpatient & Outpatient Claims, analyze the vouchers/medical documents, categorize the advantages as per the SOP and approve/reject basis the SOP
- Provide guidance and support to facilitate junior advisors resolve complex claims
- Identify potential fraud, waste, and abuse (FWA) Flag suspicious cases, highlight patterns, and work with compliance teams to ensure early detection and escalation.
📌 Insurance Manual Claim Adjudication Professional (Bengaluru)
🏢 Han Digital Solution
📍 Bengaluru