Job Description

Responsibilities:

• Scrutiny of intimation received from the panel hospital / clients.
• Approval and Issuance of Credit Letters to Jubilee Health’s panel Hospital and clients as per terms and conditions of the policy.
• Advice /Initiate Claims Investigations of claims purely on Personal Judgment.
• Coordination with the Hospital Management / Claims Section, Jubilee Health.
• Coordinate with Customer Service Officer for assisting client / patient at the panel hospital.
• Coordinate with Case Manager for access to patient medical Information.
• Coordinate with Corporate Section of the Hospital
• Coordination with doctors of other shifts for continuity of patient care
• Attend Client Queries as per pre-defined Terms and Conditions of the policy
• Suggest ways and means to bring improvements in the present work process.
• Communicate with Attending doctors and clients in clarifying Jubilee Health policy terms and conditions
• Overall supervision of 24 / 7 Approval Centre
• Maintenance of Approval TATs within acceptable level
• 24 / 7 Help line handling to facilitate clients and Corporate Sections of Panel Hospitals.
• Training and guidance to Approval Centre staff on issuance of Credit Letter with medical necessity.

Qualification:

MBBS (Complete House Job)

Experience:

1-2 years’ experience in a hospital

Other Skills:                  

Good interpersonal and communication skills.