Executive

Key Responsibilities:

• Responsible for Counselling of the patients for insurance policy exclusions and inclusions·
•  Responsible for to get the preauth request filled from consultant.
•  Responsible for to encourage the patients to take pre-approvals for planned procedures ·
• Responsible for to raise cashless request to concerned TPA through claim buddy portal and to take approvals within TAT ·
• Ensure that the follow-up for early approval ·
• Ensure that the query should be resolved from the treating doctor/patient.
• Responsible for monitoring the approval status of the patient and Sum Insured Limit ·
• Responsible for to raise the enhancements if credit limit exceeds PA approved ·
• Responsible for the update the billing team about approval status on daily basis to control outstanding’s ·
• Responsible for to intimate the concerned patient / management for denial or limit exhaust cases ·
• Responsible for to intimate TPA for the additional procedures done ·
• Coordinate with IP coordinators and IP billing team for smoothly discharge of the patients ·
• To take final approval within TAT and inform the IP Billing team for discharge·
• To manage department on Sunday/ holidays as per roaster.
• All other work assigned by management / HOD time to time.