BDS/BHMS/BAMS/ MBBS- Claims (Karnataka)

vision manpower solutions – Date posted: 27 Jun 2015
To do scrutiny of claim files and give opinion on decision.

· To ensure timely processing of claims and accurate payments of claims.

· To ensure adherence to TAT in various sub processes in claims department.

· To review IRs/rejections of claims and implementation of actionable periodically.

· To monitor and control error rates and consistency in processing.

· To Monitor Productivity in Claims processing and Cashless processing.

· To review SOP for claims processing and to develop & execute better processes.

· To manage individual KRA’s for achieving organizational goal.

· To monitor and appraise performance of doctors working under vertical.

· Review of Daily MIS to manage inflows and outflows of claims

· To monitor customer complaints, trend and timely resolution….

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