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Health Investigation Manager

2.00 to 7.00 Years   Jaipur   19 Oct, 2024
RightMatch HR Services Pvt Ltd
Job LocationJaipur
EducationNot Mentioned
SalaryNot Disclosed
IndustryInsurance
Functional AreaPharmacist / Medical RepresentativeDoctor
EmploymentTypeFull-time

Job Description

    Company - Leading General Insurance CompanyTitle - Health Investigation ManagerLocation - JaipurEducation - MBBS/ BHMS / BAMS/ BDS / D Pharm / B Pharm / PhysiotherapistWork Days- 5 (Mon- Fri)Vertical: ICLM Health InvestigationsRole: Investigation Manager and have to manage daily workload of 15 to 20 claims end to end1. Triaging of claims from a larger pool.2. Conducting ground inquiries to verify cashless/reimbursement/death/disability claims, including meetings with insured/claimants, site checks, hospital visits, and collecting relevant documents and statements.3. Allocating claims to internal and external resources.4. Taking regular and timely follow-up of allocated claims with internal and external resources.5. Carry out audits on the closure provided by internal and external resources.6. Have a strong hold on allocated claims and get the desired result by involving in real time discussion with external resources.7. Maintain TAT and success ration as per the standard regional.8. Have to be ready to go down on ground as and when required to investigate health claims.9. Have to be open to travel across the state in hospitals.Medicine graduate(MBBS/BDS/ BHMS/BAMS/ DHMS/ BUMS/ Physiotherapist) 2-3 Years of relevant field verification experienceExperienced in basic clinical and investigative skills, with 2-3 years in hospital settings and field investigations for health and benefit claims.

Keyskills :
claims investigationshealth claimshealth insuranceclaims processing

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