Health Insurance Reimbursement Claims Verification Opening– CTC UPTO 6.0 L/A (Ref code: VAMS)

Alligoric Management Solutions; Ernakulam; On-site; INR 360,000 - 600,000; Full time

Job summary

Alligoric Management Solutions in Kochi is seeking a Claim Facilitator to handle field investigations for cashless and reimbursement cases. The role requires timely action, accuracy, and coordination with multiple departments.

The candidate should be a Graduate with 1–7 years in field investigation and possess a valid two-wheeler driving license. Age should be 36 or below, and the team operates within a demanding environment.

Qualifications

• Candidate should be a Graduate.
• 1-7 years of experience in Field Investigation.
• Age should not be beyond 36 years.

Responsibilities

• Investigate Cashless & Spot cases within 24 hours of allocation.
• Investigate Reimbursement cases within 15 days of allocation.
• Perform Pre-Quality Check of Cashless and Reimbursement Claims.
• Close own cases with quality and accuracy.
• Check previous claim documents before starting investigation.
• Adhere to agreed TAT and ensure accuracy.
• Highlight fraud-proven hospital names to Central team with findings.
• Prepare case reports with quality.
• Maintain daily sheet of all investigation cases.
• Coordinate with different functions.
• Work well in highly competitive environment.

Skills

Field Investigation

Attention to Detail

Communication Skills

Two Wheeler Driving

Education

Graduate

Medical/Paramedical/Pharmacy/Forensic Science/Life Science

Tools

Two Wheeler

Driving License

Job description

Job Description

• 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

Desired Candidate Profile

• Candidate should be a Graduate
• 1-7 years of experience Required in Field Investigation
• Age should not be beyond 36 years

Locations

• KOCHI- 4 vacancy

CTC Upto 6.0 L/A
Designation -Claim Facilitator
Department- Field Operations
Qualification- Medical/ Paramedical/ Pharmacy/ Forensic Science/ Life Science
Two Wheeler & Valid Driving License- Mandatory