Urgent Requirement For the Medical Advisor
- Raksha Health
- 1 - 4 years
- Jaipur
- 4 years ago
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Job Description
Job Description:Location- Jaipur
Qualification- Bams,Bhms,Bums,Bams, BDS Only
Position- Medical Advisor ROLES AND RESPONSIBLTY-
Must have effective communication skills.
Candidate must have sound knowledge about claims hospitals and TPA.
Excellent diagnostic skills using clinical knowledge and x-rays.
Excellent knowledge about Insurance policy terms and conditions
Good knowledge about medical admissibility of claims
Good knowledge of clinical practices and protocols.
Excellent in terms of patient friendly.
Answering patient queries regarding status of claims
Answering queries regarding grievance requests raised by
patients or hospitals.
Scrutiny of files to determine if the claims do really qualify to be
reimbursed or to be settled.
reimbursed or to be settled.
To determine if the amount of the claims requested fits into SOC
(Schedule of Charges) or PPN criteria
(Schedule of Charges) or PPN criteria
To verify if all the investigation reports have been submitted along with the claims
To make sure that intimation is received from the patient depending upon the type of claim i.e. cashless or non cashless (Claims Intimation)
To verify if all the document submission has been completed in time by t he patients(Claim Document Submission).
Job Classification
Industry: Insurance,Functional Area: Financial Services, Banking, Investments, Insurance,
Role Category: Operations/Processes/Finance/Legal
Role: Operations/Processes/Finance/Legal
Employement Type: Full time
Education
Under Graduation: BDS in Dentistry, B.U.M.S in Any Specialization, BAMS in Any Specialization, BHMS in Any SpecializationPost Graduation: Post Graduation Not Required
Doctorate: Any Doctorate in Any Specialization
Contact Details:
Company: Raksha Health+ View Contact
Keyskills: Bhms Effective Communication Skills Medical Bams
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Raksha Health
Raksha Health Insurance TPA Pvt. Ltd. Raksha Health Insurance TPA Pvt.Ltd. is one of the premier and most comprehensive Health service facilitator in the Indian Market.
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