Healthcare Assistant

Job Duties & Responsibilities Play as an intermediate role Between the Insurance co. and Hospital and We Assist Team. Adjudicating cashless and Reimbursement claims with claim documents provided by help desk executive. Should be able to do claim tabulation to bifurcate payable and non-payable items as per the terms and conditions laid out in the insurance policy. Evaluating claims and posting remarks in what’s app group and updating in CRM. Monitoring billing as per the Tariff. Managing claims escalations from hospitals. Responsible to handling queries raised by insurance company / TPAs Provide technical assistance and conduct training sessions for new processors on various health insurance policies. Evaluate complete claim documents before submission. Final Approval of Tabulation done by the team Coordinate with the Internal team to understand patient enquiries. Helping team to understand the Non-medical Items. Periodically educating the claim assistance department about the changes in the policy, rules & regulations and application deduction on settlement. To create awareness about reimbursement claims. (Pre, Post & Hospitalization) and communicating the important updates to the Claims Assistance and Finance Department Be available at the office for supporting onsite staff on all six days in a week b/w 9.30am to 7.00pm Efficiently and effectively handle grievance / issue raised by hospital staff & patients, escalate issue to the team leader, Manager – Insurance Adjudication and Business Head as necessary. Follow-up on the updates to be given to the clients / onsite team of Claims Assistance Department Qualifications & Skills. BAMS / BHMS / BDS / Bsc / MSc / Nursing / Dpharm / Bpharm 0 -2 years of relevant experience Should have good analytical skills Excellent interpersonal & communication skills