Email Address Password  
Remember Login Forgot Password?
Share:




Job Description:
Managing a team of Claims Executive and monitor the claims being processed
Giving the medical advice on all the claims being received
Acting as the final authority in approving/ rejecting the claims
Allocation of investigable claims to investigators along with triggers for investigation.
Case Management
Assess quality of investigation basis findings and reports
Ensuring an error free scruitinisation of Claims raised by Insured and Hospitals in purview of approved standards for Ailment and Treatment, Patient billing covered under the medical insurance policy
Pre-Authorization to Empanelled Hospitals [CASHLESS].
Ensuring all Customer Queries are responded in defined time.
Intermittently Corporate and Hospitals visits & Hospitals investigations.
Supervising Med Claim Processing, Finalizing Claim amount Recommended by Team Doctors, reviewing and resolving Claims Problems and Appeals.
Interacting with and providing verbal and written responses to Providers, Patients, and Third Party Payers and Departmental personnel including Doctors Team.
Review daily staff processing of Cashless and Reimbursement Claims inclusive of Pre-authorization to Empanelled Hospitals, Reimbursement Claim filling and Settlement, Auditing, Grievances solving.
Reviewing and Analysis Fact and Figures on MIS. >

Manager Claims ( M B B S)

Designation / Job Role : Chief Medical Officer/Head Medical Services
Job Description :
Qualification: MBBS




Job Description:
Managing a team of Claims Executive and monitor the claims being processed
Giving the medical advice on all the claims being received
Acting as the final authority in approving/ rejecting the claims
Allocation of investigable claims to investigators along with triggers for investigation.
Case Management
Assess quality of investigation basis findings and reports
Ensuring an error free scruitinisation of Claims raised by Insured and Hospitals in purview of approved standards for Ailment and Treatment, Patient billing covered under the medical insurance policy
Pre-Authorization to Empanelled Hospitals [CASHLESS].
Ensuring all Customer Queries are responded in defined time.
Intermittently Corporate and Hospitals visits & Hospitals investigations.
Supervising Med Claim Processing, Finalizing Claim amount Recommended by Team Doctors, reviewing and resolving Claims Problems and Appeals.
Interacting with and providing verbal and written responses to Providers, Patients, and Third Party Payers and Departmental personnel including Doctors Team.
Review daily staff processing of Cashless and Reimbursement Claims inclusive of Pre-authorization to Empanelled Hospitals, Reimbursement Claim filling and Settlement, Auditing, Grievances solving.
Reviewing and Analysis Fact and Figures on MIS.
Speciality : Other
Number of Openings : 1
Hiring For : Reputed Client of Veda Corporate services
Location(s) : Delhi, Delhi/NCR(National Capital Region)
Country : India
Experience : 3 - 7 year(s)
Salary : INR 700000 - 900000 per annum
Date Posted : 26-Jan-2015
Application Deadline : Not Specified
Requirements
Education : MBBS- Medicine
Post Graduation Not Required
Doctorate Not Required
Candidate Profile : Please refer to the Job description above
Company Profile
Posted By : Mr. DocLynk Admin
Organisation Name : Medigrity
Designation : Administration
Job Reference : Not Specified
 
 
   

Physician Sign up (free)

   
First Name
Last Name
Email
Password
I accept the Privacy Policy and Terms & Conditions of DocLynk

Non-Physicians ?

Sign up Here