Medical Analyst (Only Doctors)

Role & Responsibilities:

To give Claims & Cashless/preauthorization.

Scrutiny of Medical Reimbursement Claims, and to Process Claims

Third Party Administration (Health) services (TPA)

Creating the process for claim processing (Cashless and Reimbursement).

Claims and Preauthorization Processing

High Ratio Claims Management in coordination with Networking and Empanelment Department

Monitoring the overall operations of Claims and Preauthorization.

Responsible for ensuring efficient response at the level of Preauthorization to maintain TAT.

Ensure adherence to processes and controls.

Creating the process for claim processing (Cashless and Reimbursement).

Co-ordination between Network Hospitals/Preauthorization/Claims.

Ensuring a high-quality patient care at customized/optimized cost.