Claims Manager

Full Time
Delhi NCR
Posted 1 week ago

Qualification: BAMS/BHMS/BUMS/MBBS/BDS
Role: Claims Manager Accident & Health Claims
Job Location: Noida

Job Description:

 

  • Ensure accurate claim payout – 100% compliance.
  • Being updated with policy ¬†terms and conditions to ensure prudent adjudication of claims.
  • Attention to detail with regards to identification of fraud triggers in day to day claim processing.
  • Verifying the tariff from providers in cashless payments.
  • Logical and technical reasoning for high value claims.
  • Ensure good inter and intra departmental rapport with all stakeholders to ensure seamless processing.
  • Minimizing customer grievance by avoiding improper technical opinion.
  • Being updated with the latest claim processing guidelines issued from time to time.
  • Knowledge of day to day market trends in health Insurance, particularly in the line of claim processing.
  • Stringent process related compliance ensuring the correct hospital details, member details and so on.
  • Ensure compliance and adhering to defined turnaround time (TAT).
  • All queries to be raised in one go barring exceptional claims or situations.
  • All queries to be raised in one go barring exceptional claims or situations.
  • Getting updated with latest developments in field of medicine & health insurance.

 

Skills Required:

  • Knowledge of types of Hepatitis.
  • Knowledge of types of Malaria.
  • Knowledge of Dengue.
  • Pre existing conditions of Body.
  • Normal Platelets Count.
  • Normal TLC Count.
  • Knowledge of Stroke Symptoms and Diagnosis.
  • Knowledge of Different Diseases Symptoms and Diagnosis.

 

 

 

 

Job Features

Job CategoryBFSI

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