Scrutinize and verify the medical admissibility of claims by confirming the diagnosis and treatment details against the insurance policy's terms and conditions.
Compliance & Quality:
Ensure that operations adhere to clinical guidelines and government directives, and perform quality control checks on claim information.
Fraud Detection:
Identify bill inflations or discrepancies in medical billing and verify the authenticity of medical reports.
Communication:
Handle escalations and coordinate with hospitals and beneficiaries to resolve discrepancies or denials.
Approvals:
Approve or deny claims within a specified turnaround time (TAT)
Job Type: Full-time
Pay: ₹25,000.00 - ₹30,000.00 per month
Benefits:
Paid sick time
Provident Fund
Work Location: In person
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