Brief Job Role & Responsibility:
-Medical Scrutiny
-Provide Medical opinion for Health Insurance Claims
-Processing of Cashless Requests & Health Insurance Claim -Documents
-Proficient with medical terms & system.
-Understanding of Policy terms & conditions & Various Protocols / Guidelines
-Understanding of Claims adjudication / Claims Processing
-Maintaining & Ensuring Standard Operating Procedures & Protocols
-Ailment Wise ICD & Procedure Coding
-Manage volumes effectively & efficiently to maintain Turnaround time of processing cases
-VIP Claims Processing and TAT Maintenance
-Claim Case Management / Cost Management
-To attend Investigator meeting & site training meeting.
-To ensure protocol compliance for all the events and the procedure.
-To identify potential eligible patients.
-Assessment of inclusion & exclusion criteria.
-To participate in informing the patients about clinical trials.
-Evaluating patient status for safety and assure optimum health care.
-TPA files follow-up and closure.
-Tracking of discounts/Cancelled bills/refunds/free bills/posting of packages.
-Service Recovery in the billing Area.
-Training of the HIS modules in billing with the power users.
-Proper understanding of various ailments and related clinical diagnosis.
Perks and Benefits
Open / Best in Industry
Fortis Healthcare has been established with a vision to become a global leader in the field of integrated healthcare. It is one of the fastest growing integrated healthcare providers with multi-vertical presence that touches millions of lives across... Read More
