Claim Facilitator Representative

Job description

Job Location: - Western Line in Mumbai Primary Role Description: - Responsible to Investigate Cashless/Spot and Reimbursement Claims in field. Key Roles & 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 KEY STAKEHOLDERS Internal: • Customer Service and Operations Team • Claims Team Education • Any Graduate from any Background (Medical Background Preferred) Experience • 1-2 Years’ Experience in Field Investigation • Fresher can also be consider with Medical Knowledge but willing to work in field. • Knowledge of Insurance Industry • Knowledge in Computer & MS Office • Excellent Interpersonal and team working skill