Roles and responsibilities:
- Dealing with patients health care related documents.
- Ensuring error free processing of preauthorisation within agreed TAT (Turnaround time).
- Entering accurate information into the application defined by the organization.
- Review structured clinical data matching it against specified medical terms and diagnoses or procedure codes and follow established procedures defined by the insurer and the organization.
- Inform providers as needed and file completed precertification requests as per procedures.
- Any authorization not as per the limit or as per the process to be escalated to the team manager on priority.
- Any medical opinion required from the specialist to be escalated to the specialist.
- Ensuring process compliance is met as per regulatory procedures.
- Maintaining Daily excel maintenance for Pre auth cases received and processed.
Skills and Competencies:
- Medical practitioner/BDS/BHMS/BAMS or equivalent qualification
- 0-1 year experience in Pre-Authorization and Clams management.
- Sound medical knowledge and willing to work in non-clinic process.
- Experience in handling authorization is a add on.
- Should be willing to work in shifts as the department works on 24/7 function
UG:BAMS in Any Specialization,BHMS in Any Specialization,BDS in Any Specialization,B.U.M.S in Any Specialization
Vidal Health Insurance
Contact Company:Vidal Health Insurance
Address:TOWER 2, 1ST FLOOR,PLOT NO.13,14,15,,SJR I PARK,EP, IP AREA,WHITEFIELD, BANGALORE, Karnataka, India