POSITION OVERVIEW
This position works for the hospital empanelment to increase the network of the hospitals.
ROLE AND RESPONSIBILITIES
- Should have experience in empanelment process creating a good network of hospitals to provide cashless for RGICL customers.
- Quality check and necessary documents, including legal, financial, and operational details. These documents are reviewed to ensure compliance with regulatory requirements and industry standards.
- Should be comfortable to travel to multiple hospitals
- Have knowledge in payment disputes & grievances i.e. disputes over claim amounts, eligibility, or documentation, Denials due to incomplete paperwork which leads to NEFT Rejections.
- Cashless Support/Anywhere cashless Providing network confirmation of hospital, due diligence of documentation required for anywhere cashless to provide seamless cashless experience to RGICL policy holders.
- Tariff knowledge and should have hospital experience
- Provider audit includes operational / clinical/ financial /compliance – Recovery & potential savings of subsequent FY.
- Identification of common usage procedure / analyse billing codes - identify for renegotiation / better discount (Virtual meeting with providers)
- Identify fraud trends & create deterrence in market.
EDUCATION & EXPERIENCE REQUIREMENTS
- BHMS/BAMS with good experience with region as a scope
- Exposure in the same role with previous organisation
PREFERRED SKILLS
- Customer First Attitude and Adaptive to change and pick-up any new task/role
- Should have good communication Skills (English, Hindi, Regional language will be added advantage)
- Should have good Convincing & Listening Skills
- Ability to learn new things and self-motivated
- Team Management Skills
- Negotiation Skills
