Proficient Minds
Job Responsibilities:
- Interact and comfort the patient/ patient attender.
- Brief the scope of services of the hospital with due diligence.
- Explain the provisions of the Medical Insurance Policy and clarify all doubts to the visitor.
- Mention the Third Party Administrator (TPA) of the medical insurance policy and explain the details of processing the claim.
- To carry out timely renewal of various MOU’s and seek more tie up’s with more insurance companies/PA’s.
- Mention the hospital policy including the discount offered if any, and payment breakdown to facilitate the approval of claim process.
- Approval for claims to be taken in respective portal.
- Address any queries raised in the portals
- Update the approvals of respective claims and monitor the pending issues.
- To carry out periodic follow ups on unsettled / pending / incorrect claims.
- Obtain all relevant documents of the patient and assist in filling up the pre-authorisation form.
- Despatch / upload patient documents on the portal for processing and obtaining approval of claims and update approved case/ claims in software.
- Ensure proper record keeping of all scanned documents should be saved in respective monthly folders in the computer.
- Enter pt details in the excel sheet
- Intimate the patient / patient dependent regarding approval of individual claims.
- Confirm the date of surgery & on the day of surgery obtain discharge summary for final approval.
- Address any queries raised in the portal after final approval.
- Despatch completed case documents to the insurance company by courier for early settlement.
Experience: 1 – 2 Years
Salary: 12,000 to 15,000
