Ensure accuracy in Pre Authorization and Patient History document before the former is send to TPA.
Communicate to the CC Manager about any possible denials before the patient is admitted by monitoring the recorded preauthorization or History sheet.
Proactively follow up on enhancements and ensure that the approval is received before the patients time of discharge.
Monitor the outstanding amount for the patient against the approved packages and inform CC manager about possible payments which the patient has to make.
Ensure that the bills are complete and according the package.
Ensure discharges for credit patients are done within 4 hours by coordinating with the ward managers.
Ensure that the files are sent to Insurance Company as per the defined TAT.
Keep a good relationship with the TPA\xe2\x80\x99s and Corporates.
Ensure accuracy of bills sent to corporates and that they are having the necessary Codes and rates with all supporting documents, thereby reducing disallowances.
Keep track of the bills send for payments and ensure that they are send within 7 days of discharge.
Desired Candidate Profile
Graduate candidate with knowledge of Mediclaim & Insurance. Candidate must ready to give 24*7 coverage as and when required.
Role:Customer Service Salary: Not Disclosed by Recruiter Industry:Medical Services / Hospital Department:Customer Success, Service & Operations Role Category:Customer Success, Service & Operations - Other Employment Type:Full Time, Permanent
Key Skills Mediclaimtpacashless insuranceHealth Insurance Skills highlighted with \xe2\x80\x98\xe2\x80\x98 are preferred keyskills Education UG:Any Graduate
Company Profile
Zydus Hospitals & Healhcare Research Pvt Ltd., Ahmedabad Zydus Hospitals is a 550 bed super specialty medical institution spanning 16 floors and 2 basement floors. This world class and highly sophisticated hospital offers all major medical specialities, subspecialities, investigation & diagnostics facilities, rehabilitation & physical therapy care, under one roof. The hospitals design ensures higher energy efficiency by allowing greater permeation of sunlight throughout the day and harnessing solar energy for hot water provisioning throughout the hospital complex. Company Info