Senior Executive - Health Insurance Claims Processing

Senior Executive Mass Health Claims

Description

• Claim registration – On Daily Basis need to register the  claims which has been assigned for processing , Scrutiny of the documents
• Reserve Setting :- Need to do the proper reserve setting on system based on the claim documents
• Technical processing  claims which has been assigned for processing for  health/ personal accident etc claims and deductions of Non-Medical charges, Standard deductions of co-payment as per the policy terms and conditions – On Daily basis need to do technical Assessment of the claims post registration of the claim which include billing of the claim as per the respective heads, Data Entry as per the standard fields in system, Deductions of non-Medical Charges as per the standard list, Co-Payment deductions as per the policy terms and condition/ Benefit charts etc.
• Co-ordination with Branch Offices/Clients/Hospitals for requirements – Need to have follow up with branches office/clients/hospitals for additional documents whenever require
• NEFT Updation – Updation of customer/insured NEFT details on system while processing the claims
• Travelling/Relocation – Candidate should be open for travelling whenever require for official work and also ready to relocate based on the organization or business requirement.

Skills Required

Claims Processing, Claim Settlement, Claims, TPA

Education/Qualification

Graduation

Desirable Skills

None