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Job Description

Job Description:

  • Evaluates and processes claims in accordance with insurance policy terms and conditions, company policies and procedures according to productivity and quality standards.
  • Ensures that targets are met for department Turnaround time, Quality and Productivity.
  • Identify and report back any type of claims observation or issues that may affect the process.
  • Collect and analyze claims data to identify and resolve errors, delayed claims, and processing issues. Providing recommendations to take steps to improve the claims processing quality standards and productivity.
  • Analyze reports from the administrative software for provider and member utilization trends and identification of areas requiring further management.
  • Support the Team leader / Manager in implementation of quality assurance programs in order to maintain standards of quality and minimize fraudulent cases.
  • Handling medical related call queries.
  • Maintain confidentiality with regard to the information being processed, stored or accessed.

Skills and qualification requirements:

  • Must be an MBBS Graduate
  • Candidates able to start immediately preferred
  • Minimum one year clinical experience


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