Job Description

Play as an intermediate role Between the Insurance co. and Hospital and We Assist Team. \xe2\x80\xa2 Adjudicating cashless and Reimbursement claims with claim documents provided by help desk executive. \xe2\x80\xa2 Should be able to do claim tabulation to bifurcate payable and non-payable items as per the terms and conditions laid out in the insurance policy. \xe2\x80\xa2 Evaluating of claims and posting the remarks in what\xe2\x80\x99s app group and updating in CRM. \xe2\x80\xa2 Monitoring billing as per the Tariff. \xe2\x80\xa2 Managing claims escalations form hospitals. \xe2\x80\xa2 Responsible to handling queries raised by insurance company / TPAs \xe2\x80\xa2 Provide technical assistance and to conduct training sessions for new processors on various health insurance policies. \xe2\x80\xa2 Evaluate complete claim documents before submission. \xe2\x80\xa2 Coordinate with Internal team to understand patient enquires. \xe2\x80\xa2 Helping team to understand the Non-medical Items. \xe2\x80\xa2 Periodically educating claim assistance department about the changes in the policy, rules & regulations and application deduction on settlement. \xe2\x80\xa2 To create awareness about reimbursement claims. (Pre, Post & Hospitalization) and communicating the important updates to the Claims Assistance and Finance Department \xe2\x80\xa2 Be available at the office for supporting onsite staff on all six days in a week b/w 9.30am to 7.00pm \xe2\x80\xa2 Efficiently and effectively handle grievance / issue raised by hospital staff & patients, escalate issue to the team leader, Manager \xe2\x80\x93 Insurance Adjudication and Business Head as necessary. \xe2\x80\xa2 Follow-up on the updates to be given to the clients / onsite team of Claims Assistance Department Qualifications & Skills. \xe2\x80\xa2 B-Pharma / D-PharmaExperience. \xe2\x80\xa2 1 -2 years of experience in TPA or Insurance claims or similar field Additional Skills. \xe2\x80\xa2 Strong verbal skills \xe2\x80\x93 Fluency in English & Kannada. \xe2\x80\xa2 Strong problem-solving skills and enthusiasm for new tasks and challenges \xe2\x80\xa2 Relationship building skills. \xe2\x80\xa2 Ability to multitask and prioritize, with a strong work ethic and attention to detail \xe2\x80\xa2 Ability to operate with a high level of confidentiality and professionalism \xe2\x80\xa2 Willingness to accept a high degree of uncertainty, jump in and help wherever needed, get hands dirty, and wear multiple hats on a fast-moving team. \xe2\x80\xa2 Should be able to manage the task assigned, while managing the tasks of the team/ team members that are assigned \xe2\x80\xa2 Should have an ability to manage and maintain smooth relationship with cross functional department such as Finance, Claims Assistance, Back-Office and Marketing Team Job Type: Full-time Salary: \xe2\x82\xb911,435.33 - \xe2\x82\xb936,914.91 per month Benefits:

• Health insurance
• Provident Fund

Schedule:

• Day shift

Supplemental pay types:

• Joining bonus

Ability to commute/relocate:

• Bengaluru, Karnataka: Reliably commute or planning to relocate before starting work (Required)

Experience:

• total work: 1 year (Preferred)

Speak with the employer
+91 7618787812