Claim Facilitator Representative-Field Operations

Niva Bupa; Ahmedabad District; Vor Ort; INR 350.000 - 500.000; Vollzeit

Zusammenfassung

Niva Bupa is seeking an investigations professional to manage cashless, spot, and reimbursement claim cases with tight deadlines from allocation date. You will perform pre-quality checks and coordinate with internal teams to ensure accurate closures.

The role requires meticulous document review, adherence to TAT, and the ability to work in a highly competitive environment, highlighting fraud risks to the central team with market feedback.

Aufgaben

• Cashless & Spot cases need to be investigated within 24 hours from the allocation date.
• Reimbursement cases need to be investigated within 15 days from the allocation date.
• Pre Quality Check of Cashless and Reimbursement Claims for further investigation and Closure of his own cases.
• Need to check Previous claims documents also before doing the investigation
• Adhere to agreed TAT and accuracy
• Should highlight Central team with Fraud Proven Hospital names on basis of his findings and market feedback.
• Cases reports to be Prepared with Quality.
• Maintain Daily Sheet of all the Investigation Cases
• Coordination with within different function
• Ability to work in highly competitive & demanding environment

Jobbeschreibung

Key Roles and Responsibilities

• Cashless & Spot cases need to be investigated within 24 hours from the allocation date.
• Reimbursement cases need to be investigated within 15 days from the allocation date.
• Pre Quality Check of Cashless and Reimbursement Claims for further investigation and Closure of his own cases.
• Need to check Previous claims documents also before doing the investigation
• Adhere to agreed TAT and accuracy
• Should highlight Central team with Fraud Proven Hospital names on basis of his findings and market feedback.
• Cases reports to be Prepared with Quality.
• Maintain Daily Sheet of all the Investigation Cases
• Coordination with within different function
• Ability to work in highly competitive & demanding environment