Job Description
Scrutiny of medical documents and adjudication
Approving medical claims,Verification of preauth request.
Process claims.
Identification of trigger factors of insurance related frauds and inform the concerned department.
Determine accuracy of medical documents
Take decision on approve/reject claims based on company guidelines.
Quick and accurate online processing of high value claims.
Maintaining the TAT
Participating in high level team discussions regarding maintaining claims ratios
TPA Industry Experience Is Mandatory
