Claim registration On Daily Basis need to register the claims which has been assigned for processing , Scrutiny of the documents
Reserve Setting :- Need to do the proper reserve setting on system based on the claim documents
Technical processing claims which has been assigned for processing for health/ personal accident etc claims and deductions of Non-Medical charges, Standard deductions of co-payment as per the policy terms and conditions On Daily basis need to do technical Assessment of the claims post registration of the claim which include billing of the claim as per the respective heads, Data Entry as per the standard fields in system, Deductions of non-Medical Charges as per the standard IRDAI list, Co-Payment deductions as per the policy terms and condition/ Benefit charts etc. NEFT Updation Updation of customer/insured NEFT details on system while processing the claims
Medical Processing claims which has been assigned for processing for Health/OPD.PA etc. decided the Medical Admissibility of Claim Based on the Documents and policy terms and conditions of claims, mentioning the ICD/PCS codes against the diagnosis
Quality Audit/Open/Close file review on daily basis Need to review the claims and process the audited claims those fall under deficient bucket
Co-ordination with Branch Offices/Clients/Hospitals for requirements Need to have follow up with branches office/clients/hospitals for additional documents whenever require
Travelling/Relocation Candidate should be open for travelling whenever require for official work and also ready to relocate based on the organization or business requirement.
