Claim Tracking & Follow-ups: Proactively track and follow up on pending cashless and reimbursement health insurance claims with TPAs and insurance companies.
Query Resolution: Coordinate with internal operations, patients, and insurers to obtain, compile, and submit required documents (PODs, original bills, prescriptions, justifications) for quick query closure.
Claim Expediting: Drive daily resolution of queries to prevent unnecessary claim rejections or delays in final settlement.
Documentation & Data Management: Maintain up-to-date status records of all active claims, dispatch tracking IDs (courier PODs), and communication logs.
Stakeholder Coordination: Serve as the main point of contact between healthcare providers, patients, and TPA desk teams.
Requirements & Qualifications
Experience: 1–3 years of hands-on experience in health insurance operations, TPA follow-ups, or hospital desk management.
Domain Knowledge: Strong understanding of health insurance claim lifecycles, cashless authorization, pre-/post-hospitalization processes, and TPA operations
Communication: Clear written and verbal communication skills for effective follow-ups and documentation.
